 HCPCS/MOD      TYPE OF CHANGE    SHORT DESCRIPTION              LONG DESCRIPTION
      CO             ADD          Outpatient ot service by ota   Outpatient occupational therapy services furnished in whole o
      CQ             ADD          Outpatient pt service by pta   Outpatient physical therapy services furnished in whole or in
      ER             ADD          Off-campus ed service          Items and services furnished by a provider-based, off-campus
      G0             ADD          Telestroke                     Telehealth services for diagnosis, evaluation, or treatment,
      QA             ADD          Avg sta day/night o2 < 1 lpm   Prescribed amounts of stationary oxygen for daytime use while
      QB             ADD          Avg day/nite o2 > 4 lpm/port   Prescribed amounts of stationary oxygen for daytime use while
      QQ             ADD          Qualified cdsm consulted       Ordering professional consulted a qualified clinical decision
      QR             ADD          Avg sta day/night o2 > 4 lpm   Prescribed amounts of stationary oxygen for daytime use while
      VM             ADD          Mdpp virtual make-up session   Medicare diabetes prevention program (mdpp) virtual make-up s
   A4563             ADD          Vag inser rectal control sys   Rectal control system for vaginal insertion, for long term us
   A5514             ADD          Mult den insert dir carv/cam   For diabetics only, multiple density insert, made by direct c
   A6460             ADD          Synthetic drsg <= 16 sq in     Synthetic resorbable wound dressing, sterile, pad size 16 sq.
   A6461             ADD          Synthetic drsg >16<=48 sq in   Synthetic resorbable wound dressing, sterile, pad size more t
   A9513             ADD          Lutetium lu 177 dotatat ther   Lutetium lu 177, dotatate, therapeutic, 1 millicurie
   A9589             ADD          Insti hexaminolevulinate hcl   Instillation, hexaminolevulinate hydrochloride, 100 mg
   B4105             ADD          Enzyme cartridge enteral nut   In-line cartridge containing digestive enzyme(s) for enteral
   C1823             ADD          Gen, neuro, trans sen/stim     Generator, neurostimulator (implantable), non-rechargeable, w
   C8937             ADD          Cad breast mri                 Computer-aided detection, including computer algorithm analys
   C9034             ADD          Injection, dexamethasone 9%    Injection, dexamethasone 9%, intraocular, 1 mcg
   C9035             ADD          Injection, aristada initio     Injection, aripiprazole lauroxil (aristada initio), 1 mg
   C9036             ADD          Injection, patisiran           Injection, patisiran, 0.1 mg
   C9037             ADD          Injection, risperidone         Injection, risperidone (perseris), 0.5 mg
   C9038             ADD          Inj mogamulizumab-kpkc         Injection, mogamulizumab-kpkc, 1 mg
   C9039             ADD          Injection, plazomicin          Injection, plazomicin, 5 mg
   C9407             ADD          Iodine i-131 iobenguane, dx    Iodine i-131 iobenguane, diagnostic, 1 millicurie
   C9408             ADD          Iodine i-131 iobenguane, tx    Iodine i-131 iobenguane, therapeutic, 1 millicurie
   C9462             ADD          Injection, delafloxacin        Injection, delafloxacin, 1 mg
   C9749             ADD          Repair nasal stenosis w/imp    Repair of nasal vestibular lateral wall stenosis with implant
   C9751             ADD          Microwave bronch, 3d, ebus     Bronchoscopy, rigid or flexible, transbronchial ablation of l
   C9752             ADD          Intraosseous des lumb/sacrum   Destruction of intraosseous basivertebral nerve, first two ve
   C9753             ADD          Intraosseous destruct add'l    Destruction of intraosseous basivertebral nerve, each additio
   C9754             ADD          Perc av fistula, direct        Creation of arteriovenous fistula,  percutaneous; direct, any
   C9755             ADD          Rf magnetic-guide av fistula   Creation of arteriovenous fistula, percutaneous using magneti
   E0447             ADD          Port o2 cont, liq over 4 lpm   Portable oxygen contents, liquid, 1 month's supply = 1 unit,
   E0467             ADD          Home vent multi-function       Home ventilator, multi-function respiratory device, also perf
   G0068             ADD          Adm of infusion drug in home   Professional services for the administration of anti-infectiv
   G0069             ADD          Adm of immune drug in home     Professional services for the administration of subcutaneous
   G0070             ADD          Adm of chemo drug in home      Professional services for the administration of chemotherapy
   G0071             ADD          Comm svcs by rhc/fqhc 5 min    Payment for communication technology-based services for 5 min
   G0076             ADD          Care manag h vst new pt 20 m   Brief (20 minutes) care management home visit for a new patie
   G0077             ADD          Care manag h vst new pt 30 m   Limited (30 minutes) care management home visit for a new pat
   G0078             ADD          Care manag h vst new pt 45 m   Moderate (45 minutes) care management home visit for a new pa
   G0079             ADD          Care manag h vst new pt 60 m   Comprehensive (60 minutes) care management home visit for a n
   G0080             ADD          Care manag h vst new pt 75 m   Extensive (75 minutes) care management home visit for a new p
   G0081             ADD          Care man h v ext pt 20 mi      Brief (20 minutes) care management home visit for an existing
   G0082             ADD          Care man h v ext pt 30 m       Limited (30 minutes) care management home visit for an existi
   G0083             ADD          Care man h v ext pt 45 m       Moderate (45 minutes) care management home visit for an exist
   G0084             ADD          Care man h v ext pt 60 m       Comprehensive (60 minutes) care management home visit for an
   G0085             ADD          Care man h v ext pt 75 m       Extensive (75 minutes) care management home visit for an exis
   G0086             ADD          Care man home care plan 30 m   Limited (30 minutes) care management home care plan oversight
   G0087             ADD          Care man home care plan 60 m   Comprehensive (60 minutes) care management home care plan ove
   G2000             ADD          Blinded conv. tx mdd clin tr   Blinded administration of convulsive therapy procedure, eithe
   G2010             ADD          Remot image submit by pt       Remote evaluation of recorded video and/or images submitted b
   G2011             ADD          Alcohol/sub abuse assess       Alcohol and/or substance (other than tobacco) abuse structure
   G2012             ADD          Brief check in by md/qhp       Brief communication technology-based service, e.g. virtual ch
   G9873             ADD          1 em core session              First medicare diabetes prevention program (mdpp) core sessio
   G9874             ADD          4 em core sessions             Four total medicare diabetes prevention program (mdpp) core s
   G9875             ADD          9 em core sessions             Nine total medicare diabetes prevention program (mdpp) core s
   G9876             ADD          2 em core ms mo 7-9 no wl      Two medicare diabetes prevention program (mdpp) core maintena
   G9877             ADD          2 em core ms mo 10-12 no wl    Two medicare diabetes prevention program (mdpp) core maintena
   G9878             ADD          2 em core ms mo 7-9 wl         Two medicare diabetes prevention program (mdpp) core maintena
   G9879             ADD          2 em core ms mo 10-12 wl       Two medicare diabetes prevention program (mdpp) core maintena
   G9880             ADD          Em 5 percent wl                The mdpp beneficiary achieved at least 5% weight loss (wl) fr
   G9881             ADD          Em 9 percent wl                The mdpp beneficiary achieved at least 9% weight loss (wl) fr
   G9882             ADD          2 em ongoing ms mo 13-15 wl    Two medicare diabetes prevention program (mdpp) ongoing maint
   G9883             ADD          2 em ongoing ms mo 16-18 wl    Two medicare diabetes prevention program (mdpp) ongoing maint
   G9884             ADD          2 em ongoing ms mo 19-21 wl    Two medicare diabetes prevention program (mdpp) ongoing maint
   G9885             ADD          2 em ongoing ms mo 22-24 wl    Two medicare diabetes prevention program (mdpp) ongoing maint
   G9890             ADD          Em bridge payment              Bridge payment: a one-time payment for the first medicare dia
   G9891             ADD          Em session reporting           Mdpp session reported as a line-item on a claim for a payable
   G9978             ADD          Remote e/m new pt 10mins       Remote in-home visit for the evaluation and management of a n
   G9979             ADD          Remote e/m new pt 20mins       Remote in-home visit for the evaluation and management of a n
   G9980             ADD          Remote e/m new pt 30 mins      Remote in-home visit for the evaluation and management of a n
   G9981             ADD          Remote e/m new pt 45mins       Remote in-home visit for the evaluation and management of a n
   G9982             ADD          Remote e/m new pt 60mins       Remote in-home visit for the evaluation and management of a n
   G9983             ADD          Remote e/m est. pt 10mins      Remote in-home visit for the evaluation and management of an
   G9984             ADD          Remote e/m est. pt  15mins     Remote in-home visit for the evaluation and management of an
   G9985             ADD          Remote e/m est. pt 25mins      Remote in-home visit for the evaluation and management of an
   G9986             ADD          Remote e/m est. pt 40mins      Remote in-home visit for the evaluation and management of an
   G9987             ADD          Bpci advanced in home visit    Bundled payments for care improvement advanced (bpci advanced
   J0185             ADD          Inj., aprepitant, 1 mg         Injection, aprepitant, 1 mg
   J0517             ADD          Inj., benralizumab, 1 mg       Injection, benralizumab, 1 mg
   J0567             ADD          Inj., cerliponase alfa 1 mg    Injection, cerliponase alfa, 1 mg
   J0584             ADD          Injection, burosumab-twza 1m   Injection, burosumab-twza 1 mg
   J0599             ADD          Inj., haegarda 10 units        Injection, c-1 esterase inhibitor (human), (haegarda), 10 uni
   J0841             ADD          Inj crotalidae im f(ab')2 eq   Injection, crotalidae immune f(ab')2 (equine), 120 mg
   J1301             ADD          Injection, edaravone, 1 mg     Injection, edaravone, 1 mg
   J1454             ADD          Inj fosnetupitant, palonoset   Injection, fosnetupitant 235 mg and palonosetron 0.25 mg
   J1628             ADD          Inj., guselkumab, 1 mg         Injection, guselkumab, 1 mg
   J1746             ADD          Inj., ibalizumab-uiyk, 10 mg   Injection, ibalizumab-uiyk, 10 mg
   J2062             ADD          Loxapine for inhalation 1 mg   Loxapine for inhalation, 1 mg
   J2797             ADD          Inj., rolapitant, 0.5 mg       Injection, rolapitant, 0.5 mg
   J3245             ADD          Inj., tildrakizumab, 1 mg      Injection, tildrakizumab, 1 mg
   J3304             ADD          Inj triamcinolone ace xr 1mg   Injection, triamcinolone acetonide, preservative-free, extend
   J3316             ADD          Inj., triptorelin xr 3.75 mg   Injection, triptorelin, extended-release, 3.75 mg
   J3397             ADD          Inj., vestronidase alfa-vjbk   Injection, vestronidase alfa-vjbk, 1 mg
   J3398             ADD          Inj luxturna 1 billion vec g   Injection, voretigene neparvovec-rzyl, 1 billion vector genom
   J3591             ADD          Esrd on dialysi drug/bio noc   Unclassified drug or biological used for esrd on dialysis
   J7170             ADD          Inj., emicizumab-kxwh 0.5 mg   Injection, emicizumab-kxwh, 0.5 mg
   J7177             ADD          Inj., fibryga, 1 mg            Injection, human fibrinogen concentrate (fibryga), 1 mg
   J7203             ADD          Factor ix recomb gly rebinyn   Injection factor ix, (antihemophilic factor, recombinant), gl
   J7318             ADD          Inj, durolane 1 mg             Hyaluronan or derivative, durolane, for intra-articular injec
   J7329             ADD          Inj, trivisc 1 mg              Hyaluronan or derivative, trivisc, for intra-articular inject
   J9044             ADD          Inj, bortezomib, nos, 0.1 mg   Injection, bortezomib, not otherwise specified, 0.1 mg
   J9057             ADD          Inj., copanlisib, 1 mg         Injection, copanlisib, 1 mg
   J9153             ADD          Inj daunorubicin, cytarabine   Injection, liposomal, 1 mg daunorubicin and 2.27 mg cytarabin
   J9173             ADD          Inj., durvalumab, 10 mg        Injection, durvalumab, 10 mg
   J9229             ADD          Inj inotuzumab ozogam 0.1 mg   Injection, inotuzumab ozogamicin, 0.1 mg
   J9311             ADD          Inj rituximab, hyaluronidase   Injection, rituximab 10 mg and hyaluronidase
   J9312             ADD          Inj., rituximab, 10 mg         Injection, rituximab, 10 mg
   L8608             ADD          Arg ii ext com/sup/acc misc    Miscellaneous external component, supply or accessory for use
   L8698             ADD          Misc used with tot art heart   Miscellaneous component, supply or accessory for use with tot
   L8701             ADD          Pow ue rom dev ewh uprt cust   Powered upper extremity range of motion assist device, elbow,
   L8702             ADD          Pow ue rom dev ewhf uprt cus   Powered upper extremity range of motion assist device, elbow,
   M1000             ADD          Pain scr as mod to sevr        Pain screened as moderate to severe
   M1001             ADD          Pln to adrs pain doc           Plan of care to address moderate to severe pain documented on
   M1002             ADD          Pln to adrs pain not doc       Plan of care for moderate to severe pain not documented on or
   M1003             ADD          Tb scr 12 mo pri fst bio dz    Tb screening performed and results interpreted within twelve
   M1004             ADD          Doc med rsn no srn tb          Documentation of medical reason for not screening for tb or i
   M1005             ADD          Tb scr no perf                 Tb screening not performed or results not interpreted, reason
   M1006             ADD          Dz not ases, no rsn            Disease activity not assessed, reason not given
   M1007             ADD          >=50% total pt outpt ra enct   >=50% of total number of a patient's outpatient ra encounters
   M1008             ADD          <50% total pt outpt ra encts   <50% of total number of a patient's outpatient ra encounters
   M1009             ADD          Pt tx and final eval comp      Patient treatment and final evaluation complete
   M1010             ADD          Pt tx and final eval comp      Patient treatment and final evaluation complete
   M1011             ADD          Pt tx and final eval comp      Patient treatment and final evaluation complete
   M1012             ADD          Pt tx and final eval comp      Patient treatment and final evaluation complete
   M1013             ADD          Pt tx and final eval comp      Patient treatment and final evaluation complete
   M1014             ADD          Pt tx and final eval comp      Patient treatment and final evaluation complete
   M1015             ADD          Pt tx and final eval comp      Patient treatment and final evaluation complete
   M1016             ADD          Pt dx meop or sur steri        Female patients unable to bear children
   M1017             ADD          Pt admt to palitve serv        Patient admitted to palliative care services
   M1018             ADD          Pt dx hst cr pt sk lg cr scr   Patients with an active diagnosis or history of cancer (excep
   M1019             ADD          Adl pt mj dep ds rs 12 phq<5   Adolescent patients 12 to 17 years of age with major depressi
   M1020             ADD          Adl pt mj dep ds no rs 12 mo   Adolescent patients 12 to 17 years of age with major depressi
   M1021             ADD          Pt uc in pp                    Patient had only urgent care visits during the performance pe
   M1022             ADD          Pt hospice during perf pd      Patients who were in hospice at any time during the performan
   M1023             ADD          Adl pt mj dep ds rs 6 phq<5    Adolescent patients 12 to 17 years of age with major depressi
   M1024             ADD          Adl pt mj dep ds no rs 6 mo    Adolescent patients 12 to 17 years of age with major depressi
   M1025             ADD          Pt hospice during perf pd      Patients who were in hospice at any time during the performan
   M1026             ADD          Pt hospice during perf pd      Patients who were in hospice at any time during the performan
   M1027             ADD          Img head (ct or mri) obtnd     Imaging of the head (ct or mri) was obtained
   M1028             ADD          Doc of pt prm hda dx and otr   Documentation of patients with primary headache diagnosis and
   M1029             ADD          Doc sysm rsn img hd            Imaging of the head (ct or mri) was not obtained, reason not
   M1030             ADD          Pt clin ind img hd             Patients with clinical indications for imaging of the head
   M1031             ADD          Pt clin ind img hd             Patients with no clinical indications for imaging of the head
   M1032             ADD          Adt tkng pharmthry for oud     Adults currently taking pharmacotherapy for oud
   M1033             ADD          Pharmthry for oud afr 6.30     Pharmacotherapy for oud initiated after june 30th of performa
   M1034             ADD          Adt 180 dys pharmthry oud      Adults who have at least 180 days of continuous pharmacothera
   M1035             ADD          Adt pd out mat pr 180 dys tx   Adults who are deliberately phased out of medication assisted
   M1036             ADD          Adt no 180 dys pharmthry oud   Adults who have not had at least 180 days of continuous pharm
   M1037             ADD          Pt dx lum sp reg cacr          Patients with a diagnosis of lumbar spine region cancer at th
   M1038             ADD          Pt dx lum sp reg fract         Patients with a diagnosis of lumbar spine region fracture at
   M1039             ADD          Pt dx lum sp reg inf           Patients with a diagnosis of lumbar spine region infection at
   M1040             ADD          Pt dx lum idi or cong scol     Patients with a diagnosis of lumbar idiopathic or congenital
   M1041             ADD          Pt cr ft inf lm or pt id sl    Patient had cancer, fracture or infection related to the lumb
   M1042             ADD          Ftl st mea sco ot odi 3 mo     Functional status measurement with score was obtained utilizi
   M1043             ADD          Ftl st mea sco no ot odi       Functional status measurement with score was not obtained uti
   M1044             ADD          Ftl st mea odi 3 mo            Functional status was measured by the oswestry disability ind
   M1045             ADD          Fsm wth scr oks pre and post   Functional status measurement with score was obtained utilizi
   M1046             ADD          Fsm wth scr no oks pre and p   Functional status measurement with score was not obtained uti
   M1047             ADD          Fs msrd oks pre and post       Functional status was measured by the oxford knee score (oks)
   M1048             ADD          Fsm wth scr odi pre and post   Functional status measurement with score was obtained utilizi
   M1049             ADD          Fsm wth scr no odi pre and p   Functional status measurement with score was not obtained uti
   M1050             ADD          Fs msrd odi pre and post       Functional status was measured by the oswestry disability ind
   M1051             ADD          Pt w/cancer scoliosis          Patient had cancer, fracture or infection related to the lumb
   M1052             ADD          Lg pn nt msr vas scl pre/pst   Leg pain was not measured by the visual analog scale (vas) wi
   M1053             ADD          Pre and post vas wthn 3 mos    Leg pain was measured by the visual analog scale (vas) within
   M1054             ADD          Pt uc in pp                    Patient had only urgent care visits during the performance pe
   M1055             ADD          Aspirin used                   Aspirin or another antiplatelet therapy used
   M1056             ADD          Presc antico med in pp         Prescribed anticoagulant medication during the performance pe
   M1057             ADD          Aspirin not used, no rsn       Aspirin or another antiplatelet therapy not used, reason not
   M1058             ADD          Pt prm nurs hm res in pp       Patient was a permanent nursing home resident at any time dur
   M1059             ADD          Pt no prm nurs hm res in pp    Patient was in hospice or receiving palliative care at any ti
   M1060             ADD          Pt died in pp                  Patient died prior to the end of the performance period
   M1061             ADD          Pt preg                        Patient pregnancy
   M1062             ADD          Pt imcomprmd                   Patient immunocompromised
   M1063             ADD          Pt rec hg dos imsup thpy       Patients receiving high doses of immunosuppressive therapy
   M1064             ADD          Shing vac doc adm or pv rec    Shingrix vaccine documented as administered or previously rec
   M1065             ADD          Shing vac no adm clinc rsn     Shingrix vaccine was not administered for reasons documented
   M1066             ADD          Shing vac no doc no rsn        Shingrix vaccine not documented as administered, reason not g
   M1067             ADD          Hspc pt prv time meam per      Hospice services for patient provided any time during the mea
   M1068             ADD          Pt not ambulatory              Adults who are not ambulatory
   M1069             ADD          Pt scr ft fall rsk             Patient screened for future fall risk
   M1070             ADD          Pt not scrn fut fall no rsn    Patient not screened for future fall risk, reason not given
   M1071             ADD          Pt had add'l sp pcr perf       Patient had any additional spine procedures performed on the
   Q2042             ADD          Tisagenlecleucel car-pos t     Tisagenlecleucel, up to 600 million car-positive viable t cel
   Q4183             ADD          Surgigraft, 1 sq cm            Surgigraft, per square centimeter
   Q4184             ADD          Cellesta, 1 sq cm              Cellesta, per square centimeter
   Q4185             ADD          Cellesta flowab amnion 0.5cc   Cellesta flowable amnion (25 mg per cc); per 0.5 cc
   Q4186             ADD          Epifix 1 sq cm                 Epifix, per square centimeter
   Q4187             ADD          Epicord 1 sq cm                Epicord, per square centimeter
   Q4188             ADD          Amnioarmor 1 sq cm             Amnioarmor, per square centimeter
   Q4189             ADD          Artacent ac, 1 mg              Artacent ac, 1 mg
   Q4190             ADD          Artacent ac 1 sq cm            Artacent ac, per square centimeter
   Q4191             ADD          Restorigin 1 sq cm             Restorigin, per square centimeter
   Q4192             ADD          Restorigin, 1 cc               Restorigin, 1 cc
   Q4193             ADD          Coll-e-derm 1 sq cm            Coll-e-derm, per square centimeter
   Q4194             ADD          Novachor 1 sq cm               Novachor, per square centimeter
   Q4195             ADD          Puraply 1 sq cm                Puraply, per square centimeter
   Q4196             ADD          Puraply am 1 sq cm             Puraply am, per square centimeter
   Q4197             ADD          Puraply xt 1 sq cm             Puraply xt, per square centimeter
   Q4198             ADD          Genesis amnio membrane 1sqcm   Genesis amniotic membrane, per square centimeter
   Q4200             ADD          Skin te 1 sq cm                Skin te, per square centimeter
   Q4201             ADD          Matrion 1 sq cm                Matrion, per square centimeter
   Q4202             ADD          Keroxx (2.5g/cc), 1cc          Keroxx (2.5g/cc), 1cc
   Q4203             ADD          Derma-gide, 1 sq cm            Derma-gide, per square centimeter
   Q4204             ADD          Xwrap 1 sq cm                  Xwrap, per square centimeter
   Q5103             ADD          Injection, inflectra           Injection, infliximab-dyyb, biosimilar, (inflectra), 10 mg
   Q5104             ADD          Injection, renflexis           Injection, infliximab-abda, biosimilar, (renflexis), 10 mg
   Q5105             ADD          Inj retacrit esrd on dialysi   Injection, epoetin alfa, biosimilar, (retacrit) (for esrd on
   Q5106             ADD          Inj retacrit non-esrd use      Injection, epoetin alfa, biosimilar, (retacrit) (for non-esrd
   Q5107             ADD          Inj mvasi 10 mg                Injection, bevacizumab-awwb, biosimilar, (mvasi), 10 mg
   Q5108             ADD          Injection, fulphila            Injection, pegfilgrastim-jmdb, biosimilar, (fulphila), 0.5 mg
   Q5109             ADD          Injection, ixifi, 10 mg        Injection, infliximab-qbtx, biosimilar, (ixifi), 10 mg
   Q5110             ADD          Nivestym                       Injection, filgrastim-aafi, biosimilar, (nivestym), 1 microgr
   Q9991             ADD          Buprenorph xr 100 mg or less   Injection, buprenorphine extended-release (sublocade), less t
   Q9992             ADD          Buprenorphine xr over 100 mg   Injection, buprenorphine extended-release (sublocade), greate
   T4545             ADD          Incon disposable penile wrap   Incontinence product, disposable, penile wrap, each
   V5171             ADD          Hearing aid monaural ite       Hearing aid, contralateral routing device, monaural, in the e
   V5172             ADD          Hearing aid monaural itc       Hearing aid, contralateral routing device, monaural, in the c
   V5181             ADD          Hearing aid monaural bte       Hearing aid, contralateral routing device, monaural, behind t
   V5211             ADD          Hearing aid binaural ite/ite   Hearing aid, contralateral routing system, binaural, ite/ite
   V5212             ADD          Hearing aid binaural ite/itc   Hearing aid, contralateral routing system, binaural, ite/itc
   V5213             ADD          Hearing aid binaural ite/bte   Hearing aid, contralateral routing system, binaural, ite/bte
   V5214             ADD          Hearing aid binaural itc/itc   Hearing aid, contralateral routing system, binaural, itc/itc
   V5215             ADD          Hearing aid binaural itc/bte   Hearing aid, contralateral routing system, binaural, itc/bte
   V5221             ADD          Hearing aid binaural bte/bte   Hearing aid, contralateral routing system, binaural, bte/bte
   A5513    Coverage and Long DescMulti den insert custom mold   For diabetics only, multiple density insert, custom molded fr
   A5512       Coverage Change    Multi den insert direct form   For diabetics only, multiple density insert, direct formed, m
      ZA         Discontinued     Novartis/sandoz                Novartis/sandoz
      ZB         Discontinued     Pfizer/hospira                 Pfizer/hospira
      ZC         Discontinued     Merck/samsung bioepis          Merck/samsung bioepis
   C8904         Discontinued     Mri w/o cont, breast, uni      Magnetic resonance imaging without contrast, breast; unilater
   C8907         Discontinued     Mri w/o cont, breast, bi       Magnetic resonance imaging without contrast, breast; bilatera
   C9014         Discontinued     Injection, cerliponase alfa    Injection, cerliponase alfa, 1 mg
   C9015         Discontinued     C-1 esterase, haegarda         Injection, c-1 esterase inhibitor (human), haegarda, 10 units
   C9016         Discontinued     Inj, triptorelin ext rel       Injection, triptorelin extended release, 3.75 mg
   C9024         Discontinued     Inj, daunorubicin-cytarabine   Injection, liposomal, 1 mg daunorubicin and 2.27 mg cytarabin
   C9028         Discontinued     Inj. inotuzumab ozogamicin     Injection, inotuzumab ozogamicin, 0.1 mg
   C9029         Discontinued     Injection, guselkumab          Injection, guselkumab, 1 mg
   C9030         Discontinued     Inj copanlisib                 Injection, copanlisib, 1 mg
   C9031         Discontinued     Lutetium lu 177 dotatate, tx   Lutetium lu 177, dotatate, therapeutic, 1 mci
   C9032         Discontinued     Voretigene neparvovec-rzyl     Injection, voretigene neparvovec-rzyl, 1 billion vector genom
   C9033         Discontinued     Inj, akynzeo                   Injection, fosnetupitant 235 mg and palonosetron 0.25 mg
   C9275         Discontinued     Hexaminolevulinate hcl         Injection, hexaminolevulinate hydrochloride, 100 mg, per stud
   C9463         Discontinued     Injection, aprepitant          Injection, aprepitant, 1 mg
   C9464         Discontinued     Injection, rolapitant          Injection, rolapitant, 0.5 mg
   C9465         Discontinued     Injection, durolane            Hyaluronan or derivative, durolane, for intra-articular injec
   C9466         Discontinued     Injection, benralizumab        Injection, benralizumab, 1 mg
   C9467         Discontinued     Inj rituximab hyaluronidase    Injection, rituximab and hyaluronidase, 10 mg
   C9468         Discontinued     Inj, factor ix, rebinyn        Injection, factor ix (antihemophilic factor, recombinant), gl
   C9469         Discontinued     Inj triamcinolone acetonide    Injection, triamcinolone acetonide, preservative-free, extend
   C9492         Discontinued     Injection, durvalumab          Injection, durvalumab, 10 mg
   C9493         Discontinued     Injection, edaravone           Injection, edaravone, 1 mg
   C9497         Discontinued     Loxapine, inhalation powder    Loxapine, inhalation powder, 10 mg
   C9741         Discontinued     Impl pressure sensor w/angio   Right heart catheterization with implantation of wireless pre
   C9744         Discontinued     Abd us w/contrast              Ultrasound, abdominal, with contrast
   C9748         Discontinued     Prostatic rf water vapor tx    Transurethral destruction of prostate tissue; by radiofrequen
   C9750         Discontinued     Ins/rem-replace compl iims     Insertion or removal and replacement of intracardiac ischemia
   G9534         Discontinued     Adv brain image not ordered    Advanced brain imaging (cta, ct, mra or mri) was not ordered
   G9535         Discontinued     Normal neuro exam              Patients with a normal neurological examination
   G9536         Discontinued     Doc med reas adv brain image   Documentation of medical reason(s) for ordering an advanced b
   G9538         Discontinued     Adv brain image ordered        Advanced brain imaging (cta, ct, mra or mri) was ordered
   G9686         Discontinued     Nursing facility conference    Onsite nursing facility conference, that is separate and dist
   J0833         Discontinued     Cosyntropin injection nos      Injection, cosyntropin, not otherwise specified, 0.25 mg
   J9310         Discontinued     Rituximab injection            Injection, rituximab, 100 mg
   K0903         Discontinued     Mult den insert dir carv/cam   For diabetics only, multiple density insert, made by direct c
   Q2040         Discontinued     Tisagenlecleucel car-pos t     Tisagenlecleucel, up to 250 million car-positive viable t cel
   Q4131         Discontinued     Epifix or epicord              Epifix or epicord, per square centimeter
   Q4172         Discontinued     Puraply or puraply am          Puraply or puraply am, per square centimeter
   Q5102         Discontinued     Inj., infliximab biosimilar    Injection, infliximab, biosimilar, 10 mg
   Q9993         Discontinued     Inj., triamcinolone ext rel    Injection, triamcinolone acetonide, preservative-free, extend
   Q9994         Discontinued     Enzyme cartridge enteral nut   In-line cartridge containing digestive enzyme(s) for enteral
   Q9995         Discontinued     Inj., emicizumab-kxwh 0.5 mg   Injection, emicizumab-kxwh, 0.5 mg
   V5170         Discontinued     Within ear cros hearing aid    Hearing aid, cros, in the ear
   V5180         Discontinued     Behind ear cros hearing aid    Hearing aid, cros, behind the ear
   V5210         Discontinued     In ear bicros hearing aid      Hearing aid, bicros, in the ear
   V5220         Discontinued     Behind ear bicros hearing ai   Hearing aid, bicros, behind the ear
      QE    Long Description ChangStationary o2 @ rest <1 lpm    Prescribed amount of stationary oxygen while at rest is less
      QF    Long Description ChangStation o2 @ rest >4lpm/port   Prescribed amount of stationary oxygen while at rest exceeds
      QG    Long Description ChangStation o2 @ rest > 4 lpm      Prescribed amount of stationary oxygen while at rest is great
   A9273    Long Description ChangHot/cold botle/cap/col/wrap    Cold or hot fluid bottle, ice cap or collar, heat and/or cold
   C1889    Long Description ChangImplant/insert device, noc     Implantable/insertable device, not otherwise classified
   E0218    Long Description ChangFluid circ cold pad w pump     Fluid circulating cold pad with pump, any type
   E0483    Long Description ChangHi freq chest wall oscil sys   High frequency chest wall oscillation system, includes all ac
   G0499    Long Description ChangHepb screen high risk indiv    Hepatitis b screening in non-pregnant, high risk individual i
   G8647    Long Description ChangRafscrs ki scor >= 0           Risk-adjusted functional status change residual score for the
   G8648    Long Description ChangRafscrs ki scor < 0            Risk-adjusted functional status change residual score for the
   G8649    Long Description ChangRafscrs ki no scor             Risk-adjusted functional status change residual score for the
   G8650    Long Description ChangRafscrs ki no scor no surv     Risk-adjusted functional status change residual scores for th
   G8651    Long Description ChangRafscrs hi scor >=0            Risk-adjusted functional status change residual score for the
   G8652    Long Description ChangRafscrs hi scor < 0            Risk-adjusted functional status change residual score for the
   G8653    Long Description ChangRafscrs hi no scor             Risk-adjusted functional status change residual scores for th
   G8654    Long Description ChangRafscrs hi no scor no surv     Risk-adjusted functional status change residual score for the
   G8655    Long Description ChangRafscrs llfai scor >= 0        Risk-adjusted functional status change residual score for the
   G8656    Long Description ChangRafscrs llfai scor < 0         Risk-adjusted functional status change residual score for the
   G8657    Long Description ChangRafscrs llfai no scor          Risk-adjusted functional status change residual score for the
   G8658    Long Description ChangRafscrs llfai no scor + surv   Risk-adjusted functional status change residual score for the
   G8659    Long Description ChangRafscrs lbi scor >= 0          Risk-adjusted functional status change residual score for the
   G8660    Long Description ChangRafscrs lbi scor < 0           Risk-adjusted functional status change residual score for the
   G8661    Long Description ChangRafscrs lbi no scor            Risk-adjusted functional status change residual score for the
   G8662    Long Description ChangRafscrs lbi no scor no surv    Risk-adjusted functional status change residual score for the
   G8663    Long Description ChangRafscrs si scor >= 0           Risk-adjusted functional status change residual score for the
   G8664    Long Description ChangRafscrs si scor < 0            Risk-adjusted functional status change residual score for the
   G8665    Long Description ChangRafscrs si no scor             Risk-adjusted functional status change residual score for the
   G8666    Long Description ChangRafscrs si no scor no surv     Risk-adjusted functional status change residual score for the
   G8667    Long Description ChangRafscrs ewh scor >= 0          Risk-adjusted functional status change residual score for the
   G8668    Long Description ChangRafscrs ewh scor < 0           Risk-adjusted functional status change residual score for the
   G8669    Long Description ChangRafscrs                        Risk-adjusted functional status change residual score for the
   G8670    Long Description ChangRafscrs ewh no scor no surv    Risk-adjusted functional status change residual score for the
   G8671    Long Description ChangRafscrs goi scor >= 0          Risk-adjusted functional status change residual score for the
   G8672    Long Description ChangRafscrs goi scor < 0           Risk-adjusted functional status change residual score for the
   G8673    Long Description ChangRafscrs goi no scor            Risk-adjusted functional status change residual score for the
   G8674    Long Description ChangRafscrs neck, no msr/no foto   Risk-adjusted functional status change residual score for the
   G8709    Long Description ChangPt presc doc med rsn id uri    Patient prescribed or dispensed antibiotic for documented med
   G8749    Long Description ChangNo signs melanoma              Absence of signs of melanoma (tenderness, jaundice, localized
   G8806    Long Description ChangPerf ultrsnd to lct preg doc   Performance of trans-abdominal or trans-vaginal ultrasound an
   G8880    Long Description ChangSen lym p node biop not perf   Documentation of reason(s) sentinel lymph node biopsy not per
   G9428    Long Description ChangPatho rpt incl pt ctg          Pathology report includes the pt category and a statement on
   G9429    Long Description ChangDoc med rsn no pt cat          Documentation of medical reason(s) for not including pt categ
   G9431    Long Description ChangPatho rpt no pt ctg            Pathology report does not include the pt category and a state
   G9454    Long Description ChangNo scr hcv inf 12 mth rp       One-time screening for hcv infection not received within 12-m
   G9457    Long Description ChangPt no abd img no doc rsn       Patient did not undergo abdominal imaging and did not have a
   G9509    Long Description ChangAdit mdd dys rem 12 mnths      Adult patients 18 years of age or older with major depression
   G9511    Long Description ChangIdx evt dte phq>9 doc 12 mo    Index event date phq-9 or phq-9m score greater than 9 documen
   G9530    Long Description ChangPt mbht hd ct ord ec prov      Patient presented with a minor blunt head trauma  and had a h
   G9531    Long Description ChangPt doc                         Patient has documentation of ventricular shunt, brain tumor,
   G9532    Long Description ChangPt hd ct ord                   Patient had a head ct for trauma ordered by someone other tha
   G9537    Long Description ChangDoc sysm rsn img hd            Documentation of system reason(s) for obtaining imaging of th
   G9573    Long Description ChangAdl pt md or dys rem 6 mon     Adult patients 18 years of age or older with major depression
   G9574    Long Description ChangAdl pt md dys no rem 6 mon     Adult patients 18 years of age or older with major depression
   G9594    Long Description ChangPt mbht hd ct ord ec prov      Patient presented with a minor blunt head trauma and had a he
   G9596    Long Description ChangPed pt hd ct ord               Pediatric patient had a head ct for trauma ordered by someone
   G9612    Long Description ChangPhodoc 2 mr cec lndmk          Photodocumentation of two or more cecal landmarks to establis
   G9614    Long Description ChangPhotodoc < 2 cec lndmk         Photodocumentation of less than two cecal landmarks (i.e., no
   G9625    Long Description ChangPt bl srg 30 day pst srg       Patient sustained bladder injury at the time of surgery or di
   G9627    Long Description ChangPt no bl srg 30 day pst srg    Patient did not sustain bladder injury at the time of surgery
   G9628    Long Description ChangPt bwli srg 30 day pst srg     Patient sustained bowel injury at the time of surgery or disc
   G9630    Long Description ChangPt no bwli srg 30 day srg      Patient did not sustain a bowel injury at the time of surgery
   G9631    Long Description ChangPt ui srg 30 day pst srg       Patient sustained ureter injury at the time of surgery or dis
   G9633    Long Description ChangPt no ui srg 30 day pst srg    Patient did not sustain ureter injury at the time of surgery
   G9649    Long Description ChangPsor as doc spc bm             Psoriasis assessment tool documented meeting any one of the s
   G9651    Long Description ChangPsor as doc no spc bm          Psoriasis assessment tool documented not meeting any one of t
   G9683    Long Description ChangAcute fluid/electro disorder   Facility service(s) for the onsite acute care treatment of a
   G9685    Long Description ChangAcute nursing facility care    Physician service or other qualified health care professional
   G9727    Long Description ChangPt unable cmplt knee fs prom   Patient unable to complete the knee fs prom at admission and
   G9729    Long Description ChangPt unbl cmplt hip fs prom      Patient unable to complete the hip fs prom at admission and d
   G9731    Long Description ChangPt unbl cmplt ft/ank fs prom   Patient unable to complete the foot/ankle fs prom at admissio
   G9733    Long Description ChangPt unbl cmplt lb fs prom       Patient unable to complete the low back fs prom at admission
   G9735    Long Description ChangPt unbl cmplt shld fs prom     Patient unable to complete the shoulder fs prom at admission
   G9737    Long Description ChangPt unbl cmplt ewh fs prom      Patient unable to complete the elbow/wrist/hand fs prom at ad
   G9739    Long Description ChangPt unbl cmplt go fs prom       Patient unable to complete the general orthopedic fs prom at
   G9755    Long Description ChangDoc med rsn no fllw up         Documentation of medical reason(s) for not including a recomm
   G9764    Long Description ChangPt treatd w/oral syst or bio   Patient has been treated with a systemic medication for psori
   G9765    Long Description ChangDoc pat declined therapy       Documentation that the patient declined change in medication
   G9772    Long Description ChangDoc med rsn no temp >= 35.5    Documentation of one of the following medical reason(s) for n
   G9773    Long Description Chang1 bod temp >=35.5              At least 1 body temperature measurement equal to or greater t
   G9803    Long Description ChangPt presc 135 day trmt          Patient prescribed at least a 135 day treatment within the 18
   G9804    Long Description ChangPt not presc 135 day trmt      Patient was not prescribed at least a 135 day treatment withi
   J0834    Long Description ChangInj., cosyntropin, 0.25 mg     Injection, cosyntropin, 0.25 mg
   J7178    Long Description ChangInj human fibrinogen con nos   Injection, human fibrinogen concentrate, not otherwise specif
   J8655    Long Description ChangOral netupitant, palonosetro   Netupitant 300 mg and palonosetron 0.5 mg, oral
   J9041    Long Description ChangInj., velcade 0.1 mg           Injection, bortezomib (velcade), 0.1 mg
   K0037    Long Description ChangHi mount flip-up footrest ea   High mount flip-up footrest, each
   Q2041    Long Description ChangAxicabtagene ciloleucel car+   Axicabtagene ciloleucel, up to 200 million autologous anti-cd
   Q4133    Long Description ChangGrafix stravix prime pl sqcm   Grafix prime, grafixpl prime, stravix and stravixpl, per squa
   Q4137    Long Description ChangAmnioexcel biodexcel 1sq cm    Amnioexcel, amnioexcel plus or biodexcel, per square centimet
   Q5101    Long Description ChangInjection, zarxio              Injection, filgrastim-sndz, biosimilar, (zarxio), 1 microgram
   V5190    Long Description ChangHearing aid monaural glasses   Hearing aid, contralateral routing, monaural, glasses
   V5200    Long Description ChangDisp fee contralateral monau   Dispensing fee, contralateral, monaural
   V5230    Long Description ChangHearing aid binaural glasses   Hearing aid, contralateral routing system, binaural, glasses
   V5240    Long Description ChangDisp fee contralateral binau   Dispensing fee, contralateral routing system, binaural
      A1          No Change       Dressing for one wound         Dressing for one wound
      A2          No Change       Dressing for two wounds        Dressing for two wounds
      A3          No Change       Dressing for three wounds      Dressing for three wounds
      A4          No Change       Dressing for four wounds       Dressing for four wounds
      A5          No Change       Dressing for five wounds       Dressing for five wounds
      A6          No Change       Dressing for six wounds        Dressing for six wounds
      A7          No Change       Dressing for seven wounds      Dressing for seven wounds
      A8          No Change       Dressing for eight wounds      Dressing for eight wounds
      A9          No Change       Dressing for 9 or more wound   Dressing for nine or more wounds
      AA          No Change       Anesthesia perf by anesgst     Anesthesia services performed personally by anesthesiologist
      AD          No Change       Md supervision, >4 anes proc   Medical supervision by a physician: more than four concurrent
      AE          No Change       Registered dietician           Registered dietician
      AF          No Change       Specialty physician            Specialty physician
      AG          No Change       Primary physician              Primary physician
      AH          No Change       Clinical psychologist          Clinical psychologist
      AI          No Change       Principal physician of rec     Principal physician of record
      AJ          No Change       Clinical social worker         Clinical social worker
      AK          No Change       Non participating physician    Non participating physician
      AM          No Change       Physician, team member svc     Physician, team member service
      AO          No Change       Prov declined alt pmt method   Alternate payment method declined by provider of service
      AP          No Change       No dtmn of refractive state    Determination of refractive state was not performed in the co
      AQ          No Change       Physician service hpsa area    Physician providing a service in an unlisted health professio
      AR          No Change       Physician scarcity area        Physician provider services in a physician scarcity area
      AS          No Change       Assistant at surgery service   Physician assistant, nurse practitioner, or clinical nurse sp
      AT          No Change       Acute treatment                Acute treatment (this modifier should be used when reporting
      AU          No Change       Uro, ostomy or trach item      Item furnished in conjunction with a urological, ostomy, or t
      AV          No Change       Item w prosthetic/orthotic     Item furnished in conjunction with a prosthetic device, prost
      AW          No Change       Item w a surgical dressing     Item furnished in conjunction with a surgical dressing
      AX          No Change       Item w dialysis services       Item furnished in conjunction with dialysis services
      AY          No Change       Item/service not for esrd tx   Item or service furnished to an esrd patient that is not for
      AZ          No Change       Physician serv in dent hpsa    Physician providing a service in a dental health professional
      BA          No Change       Item w pen services            Item furnished in conjunction with parenteral enteral nutriti
      BL          No Change       Spec acquisition blood prods   Special acquisition of blood and blood products
      BO          No Change       Nutrition oral admin no tube   Orally administered nutrition, not by feeding tube
      BP          No Change       Bene electd to purchase item   The beneficiary has been informed of the purchase and rental
      BR          No Change       Bene elected to rent item      The beneficiary has been informed of the purchase and rental
      BU          No Change       Bene undecided on purch/rent   The beneficiary has been informed of the purchase and rental
      CA          No Change       Procedure payable inpatient    Procedure payable only in the inpatient setting when performe
      CB          No Change       Esrd bene part a snf-sep pay   Service ordered by a renal dialysis facility (rdf) physician
      CC          No Change       Procedure code change          Procedure code change (use 'cc' when the procedure code submi
      CD          No Change       Amcc test for esrd or mcp md   Amcc test has been ordered by an esrd facility or mcp physici
      CE          No Change       Med neces amcc tst sep reimb   Amcc test has been ordered by an esrd facility or mcp physici
      CF          No Change       Amcc tst not composite rate    Amcc test has been ordered by an esrd facility or mcp physici
      CG          No Change       Policy criteria applied        Policy criteria applied
      CH          No Change       0 percent impaired, ltd, res   0 percent impaired, limited or restricted
      CI          No Change       1 to <20 percent impaired      At least 1 percent but less than 20 percent impaired, limited
      CJ          No Change       20 to <40 percent impaired     At least 20 percent but less than 40 percent impaired, limite
      CK          No Change       40 to <60 percent impaired     At least 40 percent but less than 60 percent impaired, limite
      CL          No Change       60 to <80 percent impaired     At least 60 percent but less than 80 percent impaired, limite
      CM          No Change       80 to <100 percent impaired    At least 80 percent but less than 100 percent impaired, limit
      CN          No Change       100 percent impaired, ltd      100 percent impaired, limited or restricted
      CP          No Change       C-apc adjunctive service       Adjunctive service related to a procedure assigned to a compr
      CR          No Change       Catastrophe/disaster related   Catastrophe/disaster related
      CS          No Change       Gulf oil 2010 spill related    Item or service related, in whole or in part, to an illness,
      CT          No Change       Ct does not meet nema standa   Computed tomography services furnished using equipment that d
      E1          No Change       Upper left eyelid              Upper left, eyelid
      E2          No Change       Lower left eyelid              Lower left, eyelid
      E3          No Change       Upper right eyelid             Upper right, eyelid
      E4          No Change       Lower right eyelid             Lower right, eyelid
      EA          No Change       Esa, anemia, chemo-induced     Erythropoetic stimulating agent (esa) administered to treat a
      EB          No Change       Esa, anemia, radio-induced     Erythropoetic stimulating agent (esa) administered to treat a
      EC          No Change       Esa, anemia, non-chemo/radio   Erythropoetic stimulating agent (esa) administered to treat a
      ED          No Change       Hct>39% or hgb>13g>=3 cycle    Hematocrit level has exceeded 39% (or hemoglobin level has ex
      EE          No Change       Hct>39% or hgb>13g<3 cycle     Hematocrit level has not exceeded 39% (or hemoglobin level ha
      EJ          No Change       Subsequent claim               Subsequent claims for a defined course of therapy, e.g., epo,
      EM          No Change       Emer reserve supply (esrd)     Emergency reserve supply (for esrd benefit only)
      EP          No Change       Medicaid epsdt program svc     Service provided as part of medicaid early periodic screening
      ET          No Change       Emergency services             Emergency services
      EX          No Change       Expatriate beneficiary         Expatriate beneficiary
      EY          No Change       No md order for item/service   No physician or other licensed health care provider order for
      F1          No Change       Left hand, second digit        Left hand, second digit
      F2          No Change       Left hand, third digit         Left hand, third digit
      F3          No Change       Left hand, fourth digit        Left hand, fourth digit
      F4          No Change       Left hand, fifth digit         Left hand, fifth digit
      F5          No Change       Right hand, thumb              Right hand, thumb
      F6          No Change       Right hand, second digit       Right hand, second digit
      F7          No Change       Right hand, third digit        Right hand, third digit
      F8          No Change       Right hand, fourth digit       Right hand, fourth digit
      F9          No Change       Right hand, fifth digit        Right hand, fifth digit
      FA          No Change       Left hand, thumb               Left hand, thumb
      FB          No Change       Item provided without cost     Item provided without cost to provider, supplier or practitio
      FC          No Change       Part credit, replaced device   Partial credit received for replaced device
      FP          No Change       Svc part of family plan pgm    Service provided as part of family planning program
      FX          No Change       X-ray taken using film         X-ray taken using film
      FY          No Change       Computed radiography x-ray     X-ray taken using computed radiography technology/cassette-ba
      G1          No Change       Urr reading of less than 60    Most recent urr reading of less than 60
      G2          No Change       Urr reading of 60 to 64.9      Most recent urr reading of 60 to 64.9
      G3          No Change       Urr  reading of 65 to 69.9     Most recent urr reading of 65 to 69.9
      G4          No Change       Urr reading of 70 to 74.9      Most recent urr reading of 70 to 74.9
      G5          No Change       Urr reading of 75 or greater   Most recent urr reading of 75 or greater
      G6          No Change       Esrd patient <6 dialysis/mth   Esrd patient for whom less than six dialysis sessions have be
      G7          No Change       Payment limits do not apply    Pregnancy resulted from rape or incest or pregnancy certified
      G8          No Change       Monitored anesthesia care      Monitored anesthesia care (mac) for deep complex, complicated
      G9          No Change       Mac for at risk patient        Monitored anesthesia care for patient who has history of seve
      GA          No Change       Liability waiver ind case      Waiver of liability statement issued as required by payer pol
      GB          No Change       Claim resubmitted              Claim being re-submitted for payment because it is no longer
      GC          No Change       Resident/teaching phys serv    This service has been performed in part by a resident under t
      GD          No Change       Unit of service > mue value    Units of service exceeds medically unlikely edit value and re
      GE          No Change       Resident prim care exception   This service has been performed by a resident without the pre
      GF          No Change       Nonphysician serv c a hosp     Non-physician (e.g. nurse practitioner (np), certified regist
      GG          No Change       Payment screen mam + diagmam   Performance and payment of a screening mammogram and diagnost
      GH          No Change       Diag mammo to screening mamo   Diagnostic mammogram converted from screening mammogram on sa
      GJ          No Change       Opt out provider of er srvc    "opt out" physician or practitioner emergency or urgent servi
      GK          No Change       Actual item/service ordered    Reasonable and necessary item/service associated with a ga or
      GL          No Change       Upgraded item, no charge       Medically unnecessary upgrade provided instead of non-upgrade
      GM          No Change       Multiple transports            Multiple patients on one ambulance trip
      GN          No Change       Op speech language service     Services delivered under an outpatient speech language pathol
      GO          No Change       Op occupational therapy serv   Services delivered under an outpatient occupational therapy p
      GP          No Change       Op pt services                 Services delivered under an outpatient physical therapy plan
      GQ          No Change       Telehealth store and forward   Via asynchronous telecommunications system
      GR          No Change       Service by va resident         This service was performed in whole or in part by a resident
      GS          No Change       Epo/darbepoietin reduced 25%   Dosage of erythropoietin stimulating agent has been reduced a
      GT          No Change       Interactivetelecommunication   Via interactive audio and video telecommunication systems
      GU          No Change       Liability waiver rout notice   Waiver of liability statement issued as required by payer pol
      GV          No Change       Attending phys not hospice     Attending physician not employed or paid under arrangement by
      GW          No Change       Service unrelated to term co   Service not related to the hospice patient's terminal conditi
      GX          No Change       Voluntary liability notice     Notice of liability issued, voluntary under payer policy
      GY          No Change       Statutorily excluded           Item or service statutorily excluded, does not meet the defin
      GZ          No Change       Not reasonable and necessary   Item or service expected to be denied as not reasonable and n
      H9          No Change       Court-ordered                  Court-ordered
      HA          No Change       Child/adolescent program       Child/adolescent program
      HB          No Change       Adult program non-geriatric    Adult program, non geriatric
      HC          No Change       Adult program geriatric        Adult program, geriatric
      HD          No Change       Pregnant/parenting program     Pregnant/parenting women's program
      HE          No Change       Mental health program          Mental health program
      HF          No Change       Substance abuse program        Substance abuse program
      HG          No Change       Opioid addiction tx program    Opioid addiction treatment program
      HH          No Change       Mental hlth/substance abs pr   Integrated mental health/substance abuse program
      HI          No Change       Men hlth intel/dev disab pgm   Integrated mental health and intellectual disability/developm
      HJ          No Change       Employee assistance program    Employee assistance program
      HK          No Change       Spec hgh rsk mntl hlth pop p   Specialized mental health programs for high-risk populations
      HL          No Change       Intern                         Intern
      HM          No Change       Less than bachelor degree lv   Less than bachelor degree level
      HN          No Change       Bachelors degree level         Bachelors degree level
      HO          No Change       Masters degree level           Masters degree level
      HP          No Change       Doctoral level                 Doctoral level
      HQ          No Change       Group setting                  Group setting
      HR          No Change       Family/couple w client prsnt   Family/couple with client present
      HS          No Change       Family/couple w/o client prs   Family/couple without client present
      HT          No Change       Multi-disciplinary team        Multi-disciplinary team
      HU          No Change       Child welfare agency funded    Funded by child welfare agency
      HV          No Change       Funded state addiction agncy   Funded state addictions agency
      HW          No Change       State mntl hlth agncy funded   Funded by state mental health agency
      HX          No Change       County/local agency funded     Funded by county/local agency
      HY          No Change       Funded by juvenile justice     Funded by juvenile justice agency
      HZ          No Change       Criminal justice agncy fund    Funded by criminal justice agency
      J1          No Change       Cap no-pay for prescript num   Competitive acquisition program no-pay submission for a presc
      J2          No Change       Cap restock of emerg drugs     Competitive acquisition program, restocking of emergency drug
      J3          No Change       Cap drug unavail thru cap      Competitive acquisition program (cap), drug not available thr
      J4          No Change       Dmepos comp bid furn by hosp   Dmepos item subject to dmepos competitive bidding program tha
      JA          No Change       Administered intravenously     Administered intravenously
      JB          No Change       Administered subcutaneously    Administered subcutaneously
      JC          No Change       Skin substitute graft          Skin substitute used as a graft
      JD          No Change       Skin sub not used as a graft   Skin substitute not used as a graft
      JE          No Change       Administered via dialysate     Administered via dialysate
      JF          No Change       Compounded drug                Compounded drug
      JG          No Change       340b acquired drug             Drug or biological acquired with 340b drug pricing program di
      JW          No Change       Discarded drug not administe   Drug amount discarded/not administered to any patient
      K0          No Change       Lwr ext prost functnl lvl 0    Lower extremity prosthesis functional level 0 - does not have
      K1          No Change       Lwr ext prost functnl lvl 1    Lower extremity prosthesis functional level 1 - has the abili
      K2          No Change       Lwr ext prost functnl lvl 2    Lower extremity prosthesis functional level 2 - has the abili
      K3          No Change       Lwr ext prost functnl lvl 3    Lower extremity prosthesis functional level 3 - has the abili
      K4          No Change       Lwr ext prost functnl lvl 4    Lower extremity prosthesis functional level 4 - has the abili
      KA          No Change       Wheelchair add-on option/acc   Add on option/accessory for wheelchair
      KB          No Change       >4 modifiers on claim          Beneficiary requested upgrade for abn, more than 4 modifiers
      KC          No Change       Repl special pwr wc intrface   Replacement of special power wheelchair interface
      KD          No Change       Drug/biological dme infused    Drug or biological infused through dme
      KE          No Change       Bid under round 1 dmepos cb    Bid under round one of the dmepos competitive bidding program
      KF          No Change       Fda class iii device           Item designated by fda as class iii device
      KG          No Change       Dmepos comp bid prgm no 1      Dmepos item subject to dmepos competitive bidding program num
      KH          No Change       Dmepos ini clm, pur/1 mo rnt   Dmepos item, initial claim, purchase or first month rental
      KI          No Change       Dmepos 2nd or 3rd mo rental    Dmepos item, second or third month rental
      KJ          No Change       Dmepos pen pmp or 4-15mo rnt   Dmepos item, parenteral enteral nutrition (pen) pump or cappe
      KK          No Change       Dmepos comp bid prgm no 2      Dmepos item subject to dmepos competitive bidding program num
      KL          No Change       Dmepos mailorder comp bid      Dmepos item delivered via mail
      KM          No Change       Rplc facial prosth new imp     Replacement of facial prosthesis including new impression/mou
      KN          No Change       Rplc facial prosth old mod     Replacement of facial prosthesis using previous master model
      KO          No Change       Single drug unit dose form     Single drug unit dose formulation
      KP          No Change       First drug of multi drug u d   First drug of a multiple drug unit dose formulation
      KQ          No Change       2nd/subsqnt drg multi drg ud   Second or subsequent drug of a multiple drug unit dose formul
      KR          No Change       Rental item partial month      Rental item, billing for partial month
      KS          No Change       Glucose monitor supply         Glucose monitor supply for diabetic beneficiary not treated w
      KT          No Change       Item from noncontract supply   Beneficiary resides in a competitive bidding area and travels
      KU          No Change       Dmepos comp bid prgm no 3      Dmepos item subject to dmepos competitive bidding program num
      KV          No Change       Dmepos item, profession serv   Dmepos item subject to dmepos competitive bidding program tha
      KW          No Change       Dmepos comp bid prgm no 4      Dmepos item subject to dmepos competitive bidding program num
      KX          No Change       Documentation on file          Requirements specified in the medical policy have been met
      KY          No Change       Dmepos comp bid prgm no 5      Dmepos item subject to dmepos competitive bidding program num
      KZ          No Change       New cov not implement by m+c   New coverage not implemented by managed care
      L1          No Change       Separately payable lab test    Provider attestation that the hospital laboratory test(s) is
      LC          No Change       Lft circum coronary artery     Left circumflex coronary artery
      LD          No Change       Left ant des coronary artery   Left anterior descending coronary artery
      LL          No Change       Lease/rental (appld to pur)    Lease/rental (use the 'll' modifier when dme equipment rental
      LM          No Change       Left main coronary artery      Left main coronary artery
      LR          No Change       Laboratory round trip          Laboratory round trip
      LS          No Change       Fda-monitored iol implant      Fda-monitored intraocular lens implant
      LT          No Change       Left side                      Left side (used to identify procedures performed on the left
      M2          No Change       Medicare secondary payer       Medicare secondary payer (msp)
      MS          No Change       6-mo maint/svc fee parts/lbr   Six month maintenance and servicing fee for reasonable and ne
      NB          No Change       Drug specific nebulizer        Nebulizer system, any type, fda-cleared for use with specific
      NR          No Change       New when rented                New when rented (use the 'nr' modifier when dme which was new
      NU          No Change       New equipment                  New equipment
      P1          No Change       Normal healthy patient         A normal healthy patient
      P2          No Change       Patient w/mild syst disease    A patient with mild systemic disease
      P3          No Change       Patient w/severe sys disease   A patient with severe systemic disease
      P4          No Change       Pt w/sev sys dis threat life   A patient with severe systemic disease that is a constant thr
      P5          No Change       Pt not expect surv w/o oper    A moribund patient who is not expected to survive without the
      P6          No Change       Brain-dead pt organs removed   A declared brain-dead patient whose organs are being removed
      PA          No Change       Surgery, wrong body part       Surgical or other invasive procedure on wrong body part
      PB          No Change       Surgery, wrong patient         Surgical or other invasive procedure on wrong patient
      PC          No Change       Wrong surgery on patient       Wrong surgery or other invasive procedure on patient
      PD          No Change       Inp admit w/in 3 days          Diagnostic or related non diagnostic item or service provided
      PI          No Change       Pet tumor init tx strat        Positron emission tomography (pet) or pet/computed tomography
      PL          No Change       Progressive addition lenses    Progressive addition lenses
      PM          No Change       Post mortem                    Post mortem
      PN          No Change       Non-excepted off-campus svc    Non-excepted service provided at an off-campus, outpatient, p
      PO          No Change       Excepted off-campus service    Excepted service provided at an off-campus, outpatient, provi
      PS          No Change       Pet tumor subsq tx strategy    Positron emission tomography (pet) or pet/computed tomography
      PT          No Change       Clrctal screen to diagn        Colorectal cancer screening test; converted to diagnostic tes
      Q0          No Change       Invest clinical research       Investigational clinical service provided in a clinical resea
      Q1          No Change       Routine clinical research      Routine clinical service provided in a clinical research stud
      Q2          No Change       Demo procedure, service        Demonstration procedure/service
      Q3          No Change       Live donor surgery/services    Live kidney donor surgery and related services
      Q4          No Change       Svc exempt - ordrg/rfrng md    Service for ordering/referring physician qualifies as a servi
      Q5          No Change       Recip bill arr subs md or pt   Service furnished under a reciprocal billing arrangement by a
      Q6          No Change       Fee/time comp subst md or pt   Service furnished under a fee-for-time compensation arrangeme
      Q7          No Change       One class a finding            One class a finding
      Q8          No Change       Two class b findings           Two class b findings
      Q9          No Change       1 class b & 2 class c fndngs   One class b and two class c findings
      QC          No Change       Single channel monitoring      Single channel monitoring
      QD          No Change       Rcrdg/strg in sld st memory    Recording and storage in solid state memory by a digital reco
      QH          No Change       Oxygen cnsrvg dvc w del sys    Oxygen conserving device is being used with an oxygen deliver
      QJ          No Change       Patient in state/locl custod   Services/items provided to a prisoner or patient in state or
      QK          No Change       Med dir 2-4 cncrnt anes proc   Medical direction of two, three, or four concurrent anesthesi
      QL          No Change       Patient died after amb call    Patient pronounced dead after ambulance called
      QM          No Change       Ambulance arr by provider      Ambulance service provided under arrangement by a provider of
      QN          No Change       Ambulance furn by provider     Ambulance service furnished directly by a provider of service
      QP          No Change       Individually ordered lab tst   Documentation is on file showing that the laboratory test(s)
      QS          No Change       Monitored anesthesia care      Monitored anesthesia care service
      QT          No Change       Rcrdg/strg tape analog recdr   Recording and storage on tape by an analog tape recorder
      QW          No Change       Clia waived test               Clia waived test
      QX          No Change       Crna svc w/ md med direction   Crna service: with medical direction by a physician
      QY          No Change       Medically directed crna        Medical direction of one certified registered nurse anestheti
      QZ          No Change       Crna svc w/o med dir by md     Crna service: without medical direction by a physician
      RA          No Change       Replacement of dme item        Replacement of a dme, orthotic or prosthetic item
      RB          No Change       Replacement part, dme item     Replacement of a part of a dme, orthotic or prosthetic item f
      RC          No Change       Right coronary artery          Right coronary artery
      RD          No Change       Drug admin not incident-to     Drug provided to beneficiary, but not administered "incident-
      RE          No Change       Furnish full compliance rems   Furnished in full compliance with fda-mandated risk evaluatio
      RI          No Change       Ramus intermedius cor artery   Ramus intermedius coronary artery
      RR          No Change       Rental (dme)                   Rental (use the 'rr' modifier when dme is to be rented)
      RT          No Change       Right side                     Right side (used to identify procedures performed on the righ
      SA          No Change       Nurse practitioner w physici   Nurse practitioner rendering service in collaboration with a
      SB          No Change       Nurse midwife                  Nurse midwife
      SC          No Change       Medically necessary serv/sup   Medically necessary service or supply
      SD          No Change       Serv by home infusion rn       Services provided by registered nurse with specialized, highl
      SE          No Change       State/fed funded program/ser   State and/or federally-funded programs/services
      SF          No Change       2nd opinion ordered by pro     Second opinion ordered by a professional review organization
      SG          No Change       Asc facility service           Ambulatory surgical center (asc) facility service
      SH          No Change       2nd concurrent infusion ther   Second concurrently administered infusion therapy
      SJ          No Change       3rd concurrent infusion ther   Third or more concurrently administered infusion therapy
      SK          No Change       High risk population           Member of high risk population (use only with codes for immun
      SL          No Change       State supplied vaccine         State supplied vaccine
      SM          No Change       Second opinion                 Second surgical opinion
      SN          No Change       Third opinion                  Third surgical opinion
      SQ          No Change       Item ordered by home health    Item ordered by home health
      SS          No Change       Hit in infusion suite          Home infusion services provided in the infusion suite of the
      ST          No Change       Related to trauma or injury    Related to trauma or injury
      SU          No Change       Performed in phys office       Procedure performed in physician's office (to denote use of f
      SV          No Change       Drugs delivered not used       Pharmaceuticals delivered to patient's home but not utilized
      SW          No Change       Serv by cert diab educator     Services provided by a certified diabetic educator
      SY          No Change       Contact w/high-risk pop        Persons who are in close contact with member of high-risk pop
      SZ          No Change       Habilitative services          Habilitative services
      T1          No Change       Left foot, second digit        Left foot, second digit
      T2          No Change       Left foot, third digit         Left foot, third digit
      T3          No Change       Left foot, fourth digit        Left foot, fourth digit
      T4          No Change       Left foot, fifth digit         Left foot, fifth digit
      T5          No Change       Right foot, great toe          Right foot, great toe
      T6          No Change       Right foot, second digit       Right foot, second digit
      T7          No Change       Right foot, third digit        Right foot, third digit
      T8          No Change       Right foot, fourth digit       Right foot, fourth digit
      T9          No Change       Right foot, fifth digit        Right foot, fifth digit
      TA          No Change       Left foot, great toe           Left foot, great toe
      TB          No Change       Tracking 340b acquired drug    Drug or biological acquired with 340b drug pricing program di
      TC          No Change       Technical component            Technical component; under certain circumstances, a charge ma
      TD          No Change       Rn                             Rn
      TE          No Change       Lpn/lvn                        Lpn/lvn
      TF          No Change       Intermediate level of care     Intermediate level of care
      TG          No Change       Complex/high tech level care   Complex/high tech level of care
      TH          No Change       Ob tx/srvcs prenatl/postpart   Obstetrical treatment/services, prenatal or postpartum
      TJ          No Change       Child/adolescent program gp    Program group, child and/or adolescent
      TK          No Change       Extra patient or passenger     Extra patient or passenger, non-ambulance
      TL          No Change       Early intervention ifsp        Early intervention/individualized family service plan (ifsp)
      TM          No Change       Individualized ed prgrm(iep)   Individualized education program (iep)
      TN          No Change       Rural/out of service area      Rural/outside providers' customary service area
      TP          No Change       Med transprt unloaded vehicl   Medical transport, unloaded vehicle
      TQ          No Change       Bls by volunteer amb providr   Basic life support transport by a volunteer ambulance provide
      TR          No Change       School-based iep out of dist   School-based individualized education program (iep) services
      TS          No Change       Follow-up service              Follow-up service
      TT          No Change       Additional patient             Individualized service provided to more than one patient in s
      TU          No Change       Overtime payment rate          Special payment rate, overtime
      TV          No Change       Holiday/weekend payment rate   Special payment rates, holidays/weekends
      TW          No Change       Back-up equipment              Back-up equipment
      U1          No Change       M/caid care lev 1 state def    Medicaid level of care 1, as defined by each state
      U2          No Change       M/caid care lev 2 state def    Medicaid level of care 2, as defined by each state
      U3          No Change       M/caid care lev 3 state def    Medicaid level of care 3, as defined by each state
      U4          No Change       M/caid care lev 4 state def    Medicaid level of care 4, as defined by each state
      U5          No Change       M/caid care lev 5 state def    Medicaid level of care 5, as defined by each state
      U6          No Change       M/caid care lev 6 state def    Medicaid level of care 6, as defined by each state
      U7          No Change       M/caid care lev 7 state def    Medicaid level of care 7, as defined by each state
      U8          No Change       M/caid care lev 8 state def    Medicaid level of care 8, as defined by each state
      U9          No Change       M/caid care lev 9 state def    Medicaid level of care 9, as defined by each state
      UA          No Change       M/caid care lev 10 state def   Medicaid level of care 10, as defined by each state
      UB          No Change       M/caid care lev 11 state def   Medicaid level of care 11, as defined by each state
      UC          No Change       M/caid care lev 12 state def   Medicaid level of care 12, as defined by each state
      UD          No Change       M/caid care lev 13 state def   Medicaid level of care 13, as defined by each state
      UE          No Change       Used durable med equipment     Used durable medical equipment
      UF          No Change       Services provided, morning     Services provided in the morning
      UG          No Change       Services provided, afternoon   Services provided in the afternoon
      UH          No Change       Services provided, evening     Services provided in the evening
      UJ          No Change       Services provided, night       Services provided at night
      UK          No Change       Svc on behalf client-collat    Services provided on behalf of the client to someone other th
      UN          No Change       Two patients served            Two patients served
      UP          No Change       Three patients served          Three patients served
      UQ          No Change       Four patients served           Four patients served
      UR          No Change       Five patients served           Five patients served
      US          No Change       Six or more patients served    Six or more patients served
      V1          No Change       Demonstration modifier 1       Demonstration modifier 1
      V2          No Change       Demonstration modifier 2       Demonstration modifier 2
      V3          No Change       Demonstration modifier 3       Demonstration modifier 3
      V5          No Change       Vascular catheter              Vascular catheter (alone or with any other vascular access)
      V6          No Change       Arteriovenous graft            Arteriovenous graft (or other vascular access not including a
      V7          No Change       Arteriovenous fistula          Arteriovenous fistula only (in use with two needles)
      V8          No Change       Infection present              Infection present
      V9          No Change       No infection present           No infection present
      VP          No Change       Aphakic patient                Aphakic patient
      X1          No Change       Continuous/broad services      Continuous/broad services: for reporting services by clinicia
      X2          No Change       Continuous/focused services    Continuous/focused services: for reporting services by clinic
      X3          No Change       Episodic/broad services        Episodic/broad servies: for reporting services by clinicians
      X4          No Change       Episodic/focused services      Episodic/focused services: for reporting services by clinicia
      X5          No Change       Svc req by another clinician   Diagnostic services requested by another clinician: for repor
      XE          No Change       Separate encounter             Separate encounter, a service that is distinct because it occ
      XP          No Change       Separate practitioner          Separate practitioner, a service that is distinct because it
      XS          No Change       Separate organ/structure       Separate structure, a service that is distinct because it was
      XU          No Change       Unusual separate service       Unusual non-overlapping service, the use of a service that is
   A0021          No Change       Outside state ambulance serv   Ambulance service, outside state per mile, transport (medicai
   A0080          No Change       Noninterest escort in non er   Non-emergency transportation, per mile - vehicle provided by
   A0090          No Change       Interest escort in non er      Non-emergency transportation, per mile - vehicle provided by
   A0100          No Change       Nonemergency transport taxi    Non-emergency transportation; taxi
   A0110          No Change       Nonemergency transport bus     Non-emergency transportation and bus, intra or inter state ca
   A0120          No Change       Noner transport mini-bus       Non-emergency transportation: mini-bus, mountain area transpo
   A0130          No Change       Noner transport wheelch van    Non-emergency transportation: wheelchair van
   A0140          No Change       Nonemergency transport air     Non-emergency transportation and air travel (private or comme
   A0160          No Change       Noner transport case worker    Non-emergency transportation: per mile - case worker or socia
   A0170          No Change       Transport parking fees/tolls   Transportation ancillary: parking fees, tolls, other
   A0180          No Change       Noner transport lodgng recip   Non-emergency transportation: ancillary: lodging-recipient
   A0190          No Change       Noner transport meals recip    Non-emergency transportation: ancillary: meals-recipient
   A0200          No Change       Noner transport lodgng escrt   Non-emergency transportation: ancillary: lodging escort
   A0210          No Change       Noner transport meals escort   Non-emergency transportation: ancillary: meals-escort
   A0225          No Change       Neonatal emergency transport   Ambulance service, neonatal transport, base rate, emergency t
   A0380          No Change       Basic life support mileage     Bls mileage (per mile)
   A0382          No Change       Basic support routine suppls   Bls routine disposable supplies
   A0384          No Change       Bls defibrillation supplies    Bls specialized service disposable supplies; defibrillation (
   A0390          No Change       Advanced life support mileag   Als mileage (per mile)
   A0392          No Change       Als defibrillation supplies    Als specialized service disposable supplies; defibrillation (
   A0394          No Change       Als iv drug therapy supplies   Als specialized service disposable supplies; iv drug therapy
   A0396          No Change       Als esophageal intub suppls    Als specialized service disposable supplies; esophageal intub
   A0398          No Change       Als routine disposble suppls   Als routine disposable supplies
   A0420          No Change       Ambulance waiting 1/2 hr       Ambulance waiting time (als or bls), one half (1/2) hour incr
   A0422          No Change       Ambulance 02 life sustaining   Ambulance (als or bls) oxygen and oxygen supplies, life susta
   A0424          No Change       Extra ambulance attendant      Extra ambulance attendant, ground (als or bls) or air (fixed
   A0425          No Change       Ground mileage                 Ground mileage, per statute mile
   A0426          No Change       Als 1                          Ambulance service, advanced life support, non-emergency trans
   A0427          No Change       Als1-emergency                 Ambulance service, advanced life support, emergency transport
   A0428          No Change       Bls                            Ambulance service, basic life support, non-emergency transpor
   A0429          No Change       Bls-emergency                  Ambulance service, basic life support, emergency transport (b
   A0430          No Change       Fixed wing air transport       Ambulance service, conventional air services, transport, one
   A0431          No Change       Rotary wing air transport      Ambulance service, conventional air services, transport, one
   A0432          No Change       Pi volunteer ambulance co      Paramedic intercept (pi), rural area, transport furnished by
   A0433          No Change       Als 2                          Advanced life support, level 2 (als 2)
   A0434          No Change       Specialty care transport       Specialty care transport (sct)
   A0435          No Change       Fixed wing air mileage         Fixed wing air mileage, per statute mile
   A0436          No Change       Rotary wing air mileage        Rotary wing air mileage, per statute mile
   A0888          No Change       Noncovered ambulance mileage   Noncovered ambulance mileage, per mile (e.g., for miles trave
   A0998          No Change       Ambulance response/treatment   Ambulance response and treatment, no transport
   A0999          No Change       Unlisted ambulance service     Unlisted ambulance service
   A4206          No Change       1 cc sterile syringe&needle    Syringe with needle, sterile, 1 cc or less, each
   A4207          No Change       2 cc sterile syringe&needle    Syringe with needle, sterile 2 cc, each
   A4208          No Change       3 cc sterile syringe&needle    Syringe with needle, sterile 3 cc, each
   A4209          No Change       5+ cc sterile syringe&needle   Syringe with needle, sterile 5 cc or greater, each
   A4210          No Change       Nonneedle injection device     Needle-free injection device, each
   A4211          No Change       Supp for self-adm injections   Supplies for self-administered injections
   A4212          No Change       Non coring needle or stylet    Non-coring needle or stylet with or without catheter
   A4213          No Change       20+ cc syringe only            Syringe, sterile, 20 cc or greater, each
   A4215          No Change       Sterile needle                 Needle, sterile, any size, each
   A4216          No Change       Sterile water/saline, 10 ml    Sterile water, saline and/or dextrose, diluent/flush, 10 ml
   A4217          No Change       Sterile water/saline, 500 ml   Sterile water/saline, 500 ml
   A4218          No Change       Sterile saline or water        Sterile saline or water, metered dose dispenser, 10 ml
   A4220          No Change       Infusion pump refill kit       Refill kit for implantable infusion pump
   A4221          No Change       Supp non-insulin inf cath/wk   Supplies for maintenance of non-insulin drug infusion cathete
   A4222          No Change       Infusion supplies with pump    Infusion supplies for external drug infusion pump, per casset
   A4223          No Change       Infusion supplies w/o pump     Infusion supplies not used with external infusion pump, per c
   A4224          No Change       Supply insulin inf cath/wk     Supplies for maintenance of insulin infusion catheter, per we
   A4225          No Change       Sup/ext insulin inf pump syr   Supplies for external insulin infusion pump, syringe type car
   A4230          No Change       Infus insulin pump non needl   Infusion set for external insulin pump, non needle cannula ty
   A4231          No Change       Infusion insulin pump needle   Infusion set for external insulin pump, needle type
   A4232          No Change       Syringe w/needle insulin 3cc   Syringe with needle for external insulin pump, sterile, 3 cc
   A4233          No Change       Alkalin batt for glucose mon   Replacement battery, alkaline (other than j cell), for use wi
   A4234          No Change       J-cell batt for glucose mon    Replacement battery, alkaline, j cell, for use with medically
   A4235          No Change       Lithium batt for glucose mon   Replacement battery, lithium, for use with medically necessar
   A4236          No Change       Silvr oxide batt glucose mon   Replacement battery, silver oxide, for use with medically nec
   A4244          No Change       Alcohol or peroxide per pint   Alcohol or peroxide, per pint
   A4245          No Change       Alcohol wipes per box          Alcohol wipes, per box
   A4246          No Change       Betadine/phisohex solution     Betadine or phisohex solution, per pint
   A4247          No Change       Betadine/iodine swabs/wipes    Betadine or iodine swabs/wipes, per box
   A4248          No Change       Chlorhexidine antisept         Chlorhexidine containing antiseptic, 1 ml
   A4250          No Change       Urine reagent strips/tablets   Urine test or reagent strips or tablets (100 tablets or strip
   A4252          No Change       Blood ketone test or strip     Blood ketone test or reagent strip, each
   A4253          No Change       Blood glucose/reagent strips   Blood glucose test or reagent strips for home blood glucose m
   A4255          No Change       Glucose monitor platforms      Platforms for home blood glucose monitor, 50 per box
   A4256          No Change       Calibrator solution/chips      Normal, low and high calibrator solution / chips
   A4257          No Change       Replace lensshield cartridge   Replacement lens shield cartridge for use with laser skin pie
   A4258          No Change       Lancet device each             Spring-powered device for lancet, each
   A4259          No Change       Lancets per box                Lancets, per box of 100
   A4261          No Change       Cervical cap contraceptive     Cervical cap for contraceptive use
   A4262          No Change       Temporary tear duct plug       Temporary, absorbable lacrimal duct implant, each
   A4263          No Change       Permanent tear duct plug       Permanent, long term, non-dissolvable lacrimal duct implant,
   A4264          No Change       Intratubal occlusion device    Permanent implantable contraceptive intratubal occlusion devi
   A4265          No Change       Paraffin                       Paraffin, per pound
   A4266          No Change       Diaphragm                      Diaphragm for contraceptive use
   A4267          No Change       Male condom                    Contraceptive supply, condom, male, each
   A4268          No Change       Female condom                  Contraceptive supply, condom, female, each
   A4269          No Change       Spermicide                     Contraceptive supply, spermicide (e.g., foam, gel), each
   A4270          No Change       Disposable endoscope sheath    Disposable endoscope sheath, each
   A4280          No Change       Brst prsths adhsv attchmnt     Adhesive skin support attachment for use with external breast
   A4281          No Change       Replacement breastpump tube    Tubing for breast pump, replacement
   A4282          No Change       Replacement breastpump adpt    Adapter for breast pump, replacement
   A4283          No Change       Replacement breastpump cap     Cap for breast pump bottle, replacement
   A4284          No Change       Replcmnt breast pump shield    Breast shield and splash protector for use with breast pump,
   A4285          No Change       Replcmnt breast pump bottle    Polycarbonate bottle for use with breast pump, replacement
   A4286          No Change       Replcmnt breastpump lok ring   Locking ring for breast pump, replacement
   A4290          No Change       Sacral nerve stim test lead    Sacral nerve stimulation test lead, each
   A4300          No Change       Cath impl vasc access portal   Implantable access catheter, (e.g., venous, arterial, epidura
   A4301          No Change       Implantable access syst perc   Implantable access total catheter, port/reservoir (e.g., veno
   A4305          No Change       Drug delivery system >=50 ml   Disposable drug delivery system, flow rate of 50 ml or greate
   A4306          No Change       Drug delivery system <=50 ml   Disposable drug delivery system, flow rate of less than 50 ml
   A4310          No Change       Insert tray w/o bag/cath       Insertion tray without drainage bag and without catheter (acc
   A4311          No Change       Catheter w/o bag 2-way latex   Insertion tray without drainage bag with indwelling catheter,
   A4312          No Change       Cath w/o bag 2-way silicone    Insertion tray without drainage bag with indwelling catheter,
   A4313          No Change       Catheter w/bag 3-way           Insertion tray without drainage bag with indwelling catheter,
   A4314          No Change       Cath w/drainage 2-way latex    Insertion tray with drainage bag with indwelling catheter, fo
   A4315          No Change       Cath w/drainage 2-way silcne   Insertion tray with drainage bag with indwelling catheter, fo
   A4316          No Change       Cath w/drainage 3-way          Insertion tray with drainage bag with indwelling catheter, fo
   A4320          No Change       Irrigation tray                Irrigation tray with bulb or piston syringe, any purpose
   A4321          No Change       Cath therapeutic irrig agent   Therapeutic agent for urinary catheter irrigation
   A4322          No Change       Irrigation syringe             Irrigation syringe, bulb or piston, each
   A4326          No Change       Male external catheter         Male external catheter with integral collection chamber, any
   A4327          No Change       Fem urinary collect dev cup    Female external urinary collection device; meatal cup, each
   A4328          No Change       Fem urinary collect pouch      Female external urinary collection device; pouch, each
   A4330          No Change       Stool collection pouch         Perianal fecal collection pouch with adhesive, each
   A4331          No Change       Extension drainage tubing      Extension drainage tubing, any type, any length, with connect
   A4332          No Change       Lube sterile packet            Lubricant, individual sterile packet, each
   A4333          No Change       Urinary cath anchor device     Urinary catheter anchoring device, adhesive skin attachment,
   A4334          No Change       Urinary cath leg strap         Urinary catheter anchoring device, leg strap, each
   A4335          No Change       Incontinence supply            Incontinence supply; miscellaneous
   A4336          No Change       Urethral insert                Incontinence supply, urethral insert, any type, each
   A4337          No Change       Incontinent rectal insert      Incontinence supply, rectal insert, any type, each
   A4338          No Change       Indwelling catheter latex      Indwelling catheter; foley type, two-way latex with coating (
   A4340          No Change       Indwelling catheter special    Indwelling catheter; specialty type, (e.g., coude, mushroom,
   A4344          No Change       Cath indw foley 2 way silicn   Indwelling catheter, foley type, two-way, all silicone, each
   A4346          No Change       Cath indw foley 3 way          Indwelling catheter; foley type, three way for continuous irr
   A4349          No Change       Disposable male external cat   Male external catheter, with or without adhesive, disposable,
   A4351          No Change       Straight tip urine catheter    Intermittent urinary catheter; straight tip, with or without
   A4352          No Change       Coude tip urinary catheter     Intermittent urinary catheter; coude (curved) tip, with or wi
   A4353          No Change       Intermittent urinary cath      Intermittent urinary catheter, with insertion supplies
   A4354          No Change       Cath insertion tray w/bag      Insertion tray with drainage bag but without catheter
   A4355          No Change       Bladder irrigation tubing      Irrigation tubing set for continuous bladder irrigation throu
   A4356          No Change       Ext ureth clmp or compr dvc    External urethral clamp or compression device (not to be used
   A4357          No Change       Bedside drainage bag           Bedside drainage bag, day or night, with or without anti-refl
   A4358          No Change       Urinary leg or abdomen bag     Urinary drainage bag, leg or abdomen, vinyl, with or without
   A4360          No Change       Disposable ext urethral dev    Disposable external urethral clamp or compression device, wit
   A4361          No Change       Ostomy face plate              Ostomy faceplate, each
   A4362          No Change       Solid skin barrier             Skin barrier; solid, 4 x 4 or equivalent; each
   A4363          No Change       Ostomy clamp, replacement      Ostomy clamp, any type, replacement only, each
   A4364          No Change       Adhesive, liquid or equal      Adhesive, liquid or equal, any type, per oz
   A4366          No Change       Ostomy vent                    Ostomy vent, any type, each
   A4367          No Change       Ostomy belt                    Ostomy belt, each
   A4368          No Change       Ostomy filter                  Ostomy filter, any type, each
   A4369          No Change       Skin barrier liquid per oz     Ostomy skin barrier, liquid (spray, brush, etc.), per oz
   A4371          No Change       Skin barrier powder per oz     Ostomy skin barrier, powder, per oz
   A4372          No Change       Skin barrier solid 4x4 equiv   Ostomy skin barrier, solid 4 x 4 or equivalent, standard wear
   A4373          No Change       Skin barrier with flange       Ostomy skin barrier, with flange (solid, flexible or accordio
   A4375          No Change       Drainable plastic pch w fcpl   Ostomy pouch, drainable, with faceplate attached, plastic, ea
   A4376          No Change       Drainable rubber pch w fcplt   Ostomy pouch, drainable, with faceplate attached, rubber, eac
   A4377          No Change       Drainable plstic pch w/o fp    Ostomy pouch, drainable, for use on faceplate, plastic, each
   A4378          No Change       Drainable rubber pch w/o fp    Ostomy pouch, drainable, for use on faceplate, rubber, each
   A4379          No Change       Urinary plastic pouch w fcpl   Ostomy pouch, urinary, with faceplate attached, plastic, each
   A4380          No Change       Urinary rubber pouch w fcplt   Ostomy pouch, urinary, with faceplate attached, rubber, each
   A4381          No Change       Urinary plastic pouch w/o fp   Ostomy pouch, urinary, for use on faceplate, plastic, each
   A4382          No Change       Urinary hvy plstc pch w/o fp   Ostomy pouch, urinary, for use on faceplate, heavy plastic, e
   A4383          No Change       Urinary rubber pouch w/o fp    Ostomy pouch, urinary, for use on faceplate, rubber, each
   A4384          No Change       Ostomy faceplt/silicone ring   Ostomy faceplate equivalent, silicone ring, each
   A4385          No Change       Ost skn barrier sld ext wear   Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear
   A4387          No Change       Ost clsd pouch w att st barr   Ostomy pouch, closed, with barrier attached, with built-in co
   A4388          No Change       Drainable pch w ex wear barr   Ostomy pouch, drainable, with extended wear barrier attached,
   A4389          No Change       Drainable pch w st wear barr   Ostomy pouch, drainable, with barrier attached, with built-in
   A4390          No Change       Drainable pch ex wear convex   Ostomy pouch, drainable, with extended wear barrier attached,
   A4391          No Change       Urinary pouch w ex wear barr   Ostomy pouch, urinary, with extended wear barrier attached (1
   A4392          No Change       Urinary pouch w st wear barr   Ostomy pouch, urinary, with standard wear barrier attached, w
   A4393          No Change       Urine pch w ex wear bar conv   Ostomy pouch, urinary, with extended wear barrier attached, w
   A4394          No Change       Ostomy pouch liq deodorant     Ostomy deodorant, with or without lubricant, for use in ostom
   A4395          No Change       Ostomy pouch solid deodorant   Ostomy deodorant for use in ostomy pouch, solid, per tablet
   A4396          No Change       Peristomal hernia supprt blt   Ostomy belt with peristomal hernia support
   A4397          No Change       Irrigation supply sleeve       Irrigation supply; sleeve, each
   A4398          No Change       Ostomy irrigation bag          Ostomy irrigation supply; bag, each
   A4399          No Change       Ostomy irrig cone/cath w brs   Ostomy irrigation supply; cone/catheter, with or without brus
   A4400          No Change       Ostomy irrigation set          Ostomy irrigation set
   A4402          No Change       Lubricant per ounce            Lubricant, per ounce
   A4404          No Change       Ostomy ring each               Ostomy ring, each
   A4405          No Change       Nonpectin based ostomy paste   Ostomy skin barrier, non-pectin based, paste, per ounce
   A4406          No Change       Pectin based ostomy paste      Ostomy skin barrier, pectin-based, paste, per ounce
   A4407          No Change       Ext wear ost skn barr <=4sq"   Ostomy skin barrier, with flange (solid, flexible, or accordi
   A4408          No Change       Ext wear ost skn barr >4sq"    Ostomy skin barrier, with flange (solid, flexible or accordio
   A4409          No Change       Ost skn barr convex <=4 sq i   Ostomy skin barrier, with flange (solid, flexible or accordio
   A4410          No Change       Ost skn barr extnd >4 sq       Ostomy skin barrier, with flange (solid, flexible or accordio
   A4411          No Change       Ost skn barr extnd =4sq        Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear
   A4412          No Change       Ost pouch drain high output    Ostomy pouch, drainable, high output, for use on a barrier wi
   A4413          No Change       2 pc drainable ost pouch       Ostomy pouch, drainable, high output, for use on a barrier wi
   A4414          No Change       Ost sknbar w/o conv<=4 sq in   Ostomy skin barrier, with flange (solid, flexible or accordio
   A4415          No Change       Ost skn barr w/o conv >4 sqi   Ostomy skin barrier, with flange (solid, flexible or accordio
   A4416          No Change       Ost pch clsd w barrier/filtr   Ostomy pouch, closed, with barrier attached, with filter (1 p
   A4417          No Change       Ost pch w bar/bltinconv/fltr   Ostomy pouch, closed, with barrier attached, with built-in co
   A4418          No Change       Ost pch clsd w/o bar w filtr   Ostomy pouch, closed; without barrier attached, with filter (
   A4419          No Change       Ost pch for bar w flange/flt   Ostomy pouch, closed; for use on barrier with non-locking fla
   A4420          No Change       Ost pch clsd for bar w lk fl   Ostomy pouch, closed; for use on barrier with locking flange
   A4421          No Change       Ostomy supply misc             Ostomy supply; miscellaneous
   A4422          No Change       Ost pouch absorbent material   Ostomy absorbent material (sheet/pad/crystal packet) for use
   A4423          No Change       Ost pch for bar w lk fl/fltr   Ostomy pouch, closed; for use on barrier with locking flange,
   A4424          No Change       Ost pch drain w bar & filter   Ostomy pouch, drainable, with barrier attached, with filter (
   A4425          No Change       Ost pch drain for barrier fl   Ostomy pouch, drainable; for use on barrier with non-locking
   A4426          No Change       Ost pch drain 2 piece system   Ostomy pouch, drainable; for use on barrier with locking flan
   A4427          No Change       Ost pch drain/barr lk flng/f   Ostomy pouch, drainable; for use on barrier with locking flan
   A4428          No Change       Urine ost pouch w faucet/tap   Ostomy pouch, urinary, with extended wear barrier attached, w
   A4429          No Change       Urine ost pouch w bltinconv    Ostomy pouch, urinary, with barrier attached, with built-in c
   A4430          No Change       Ost urine pch w b/bltin conv   Ostomy pouch, urinary, with extended wear barrier attached, w
   A4431          No Change       Ost pch urine w barrier/tapv   Ostomy pouch, urinary; with barrier attached, with faucet-typ
   A4432          No Change       Os pch urine w bar/fange/tap   Ostomy pouch, urinary; for use on barrier with non-locking fl
   A4433          No Change       Urine ost pch bar w lock fln   Ostomy pouch, urinary; for use on barrier with locking flange
   A4434          No Change       Ost pch urine w lock flng/ft   Ostomy pouch, urinary; for use on barrier with locking flange
   A4435          No Change       1pc ost pch drain hgh output   Ostomy pouch, drainable, high output, with extended wear barr
   A4450          No Change       Non-waterproof tape            Tape, non-waterproof, per 18 square inches
   A4452          No Change       Waterproof tape                Tape, waterproof, per 18 square inches
   A4455          No Change       Adhesive remover per ounce     Adhesive remover or solvent (for tape, cement or other adhesi
   A4456          No Change       Adhesive remover, wipes        Adhesive remover, wipes, any type, each
   A4458          No Change       Reusable enema bag             Enema bag with tubing, reusable
   A4459          No Change       Manual pump enema, reusable    Manual pump-operated enema system, includes balloon, catheter
   A4461          No Change       Surgicl dress hold non-reuse   Surgical dressing holder, non-reusable, each
   A4463          No Change       Surgical dress holder reuse    Surgical dressing holder, reusable, each
   A4465          No Change       Non-elastic extremity binder   Non-elastic binder for extremity
   A4466          No Change       Elastic garment/covering       Garment, belt, sleeve or other covering, elastic or similar s
   A4467          No Change       Belt strap sleev grmnt cover   Belt, strap, sleeve, garment, or covering, any type
   A4470          No Change       Gravlee jet washer             Gravlee jet washer
   A4480          No Change       Vabra aspirator                Vabra aspirator
   A4481          No Change       Tracheostoma filter            Tracheostoma filter, any type, any size, each
   A4483          No Change       Moisture exchanger             Moisture exchanger, disposable, for use with invasive mechani
   A4490          No Change       Above knee surgical stocking   Surgical stockings above knee length, each
   A4495          No Change       Thigh length surg stocking     Surgical stockings thigh length, each
   A4500          No Change       Below knee surgical stocking   Surgical stockings below knee length, each
   A4510          No Change       Full length surg stocking      Surgical stockings full length, each
   A4520          No Change       Incontinence garment anytype   Incontinence garment, any type, (e.g., brief, diaper), each
   A4550          No Change       Surgical trays                 Surgical trays
   A4553          No Change       Nondisp underpads, all sizes   Non-disposable underpads, all sizes
   A4554          No Change       Disposable underpads           Disposable underpads, all sizes
   A4555          No Change       Ca tx e-stim electr/transduc   Electrode/transducer for use with electrical stimulation devi
   A4556          No Change       Electrodes, pair               Electrodes, (e.g., apnea monitor), per pair
   A4557          No Change       Lead wires, pair               Lead wires, (e.g., apnea monitor), per pair
   A4558          No Change       Conductive gel or paste        Conductive gel or paste, for use with electrical device (e.g.
   A4559          No Change       Coupling gel or paste          Coupling gel or paste, for use with ultrasound device, per oz
   A4561          No Change       Pessary rubber, any type       Pessary, rubber, any type
   A4562          No Change       Pessary, non rubber,any type   Pessary, non rubber, any type
   A4565          No Change       Slings                         Slings
   A4566          No Change       Should sling/vest/abrestrain   Shoulder sling or vest design, abduction restrainer, with or
   A4570          No Change       Splint                         Splint
   A4575          No Change       Hyperbaric o2 chamber disps    Topical hyperbaric oxygen chamber, disposable
   A4580          No Change       Cast supplies (plaster)        Cast supplies (e.g., plaster)
   A4590          No Change       Special casting material       Special casting material (e.g., fiberglass)
   A4595          No Change       Tens suppl 2 lead per month    Electrical stimulator supplies, 2 lead, per month, (e.g., ten
   A4600          No Change       Sleeve, inter limb comp dev    Sleeve for intermittent limb compression device, replacement
   A4601          No Change       Lith ion non prosth recharge   Lithium ion battery, rechargeable, for non-prosthetic use, re
   A4602          No Change       Replace lithium battery 1.5v   Replacement battery for external infusion pump owned by patie
   A4604          No Change       Tubing with heating element    Tubing with integrated heating element for use with positive
   A4605          No Change       Trach suction cath close sys   Tracheal suction catheter, closed system, each
   A4606          No Change       Oxygen probe used w oximeter   Oxygen probe for use with oximeter device, replacement
   A4608          No Change       Transtracheal oxygen cath      Transtracheal oxygen catheter, each
   A4611          No Change       Heavy duty battery             Battery, heavy duty; replacement for patient owned ventilator
   A4612          No Change       Battery cables                 Battery cables; replacement for patient-owned ventilator
   A4613          No Change       Battery charger                Battery charger; replacement for patient-owned ventilator
   A4614          No Change       Hand-held pefr meter           Peak expiratory flow rate meter, hand held
   A4615          No Change       Cannula nasal                  Cannula, nasal
   A4616          No Change       Tubing (oxygen) per foot       Tubing (oxygen), per foot
   A4617          No Change       Mouth piece                    Mouth piece
   A4618          No Change       Breathing circuits             Breathing circuits
   A4619          No Change       Face tent                      Face tent
   A4620          No Change       Variable concentration mask    Variable concentration mask
   A4623          No Change       Tracheostomy inner cannula     Tracheostomy, inner cannula
   A4624          No Change       Tracheal suction tube          Tracheal suction catheter, any type other than closed system,
   A4625          No Change       Trach care kit for new trach   Tracheostomy care kit for new tracheostomy
   A4626          No Change       Tracheostomy cleaning brush    Tracheostomy cleaning brush, each
   A4627          No Change       Spacer bag/reservoir           Spacer, bag or reservoir, with or without mask, for use with
   A4628          No Change       Oropharyngeal suction cath     Oropharyngeal suction catheter, each
   A4629          No Change       Tracheostomy care kit          Tracheostomy care kit for established tracheostomy
   A4630          No Change       Repl bat t.e.n.s. own by pt    Replacement batteries, medically necessary, transcutaneous el
   A4633          No Change       Uvl replacement bulb           Replacement bulb/lamp for ultraviolet light therapy system, e
   A4634          No Change       Replacement bulb th lightbox   Replacement bulb for therapeutic light box, tabletop model
   A4635          No Change       Underarm crutch pad            Underarm pad, crutch, replacement, each
   A4636          No Change       Handgrip for cane etc          Replacement, handgrip, cane, crutch, or walker, each
   A4637          No Change       Repl tip cane/crutch/walker    Replacement, tip, cane, crutch, walker, each.
   A4638          No Change       Repl batt pulse gen sys        Replacement battery for patient-owned ear pulse generator, ea
   A4639          No Change       Infrared ht sys replcmnt pad   Replacement pad for infrared heating pad system, each
   A4640          No Change       Alternating pressure pad       Replacement pad for use with medically necessary alternating
   A4641          No Change       Radiopharm dx agent noc        Radiopharmaceutical, diagnostic, not otherwise classified
   A4642          No Change       In111 satumomab                Indium in-111 satumomab pendetide, diagnostic, per study dose
   A4648          No Change       Implantable tissue marker      Tissue marker, implantable, any type, each
   A4649          No Change       Surgical supplies              Surgical supply; miscellaneous
   A4650          No Change       Implant radiation dosimeter    Implantable radiation dosimeter, each
   A4651          No Change       Calibrated microcap tube       Calibrated microcapillary tube, each
   A4652          No Change       Microcapillary tube sealant    Microcapillary tube sealant
   A4653          No Change       Pd catheter anchor belt        Peritoneal dialysis catheter anchoring device, belt, each
   A4657          No Change       Syringe w/wo needle            Syringe, with or without needle, each
   A4660          No Change       Sphyg/bp app w cuff and stet   Sphygmomanometer/blood pressure apparatus with cuff and steth
   A4663          No Change       Dialysis blood pressure cuff   Blood pressure cuff only
   A4670          No Change       Automatic bp monitor, dial     Automatic blood pressure monitor
   A4671          No Change       Disposable cycler set          Disposable cycler set used with cycler dialysis machine, each
   A4672          No Change       Drainage ext line, dialysis    Drainage extension line, sterile, for dialysis, each
   A4673          No Change       Ext line w easy lock connect   Extension line with easy lock connectors, used with dialysis
   A4674          No Change       Chem/antisept solution, 8oz    Chemicals/antiseptics solution used to clean/sterilize dialys
   A4680          No Change       Activated carbon filter, ea    Activated carbon filter for hemodialysis, each
   A4690          No Change       Dialyzer, each                 Dialyzer (artificial kidneys), all types, all sizes, for hemo
   A4706          No Change       Bicarbonate conc sol per gal   Bicarbonate concentrate, solution, for hemodialysis, per gall
   A4707          No Change       Bicarbonate conc pow per pac   Bicarbonate concentrate, powder, for hemodialysis, per packet
   A4708          No Change       Acetate conc sol per gallon    Acetate concentrate solution, for hemodialysis, per gallon
   A4709          No Change       Acid conc sol per gallon       Acid concentrate, solution, for hemodialysis, per gallon
   A4714          No Change       Treated water per gallon       Treated water (deionized, distilled, or reverse osmosis) for
   A4719          No Change       "y set" tubing                 "y set" tubing for peritoneal dialysis
   A4720          No Change       Dialysat sol fld vol > 249cc   Dialysate solution, any concentration of dextrose, fluid volu
   A4721          No Change       Dialysat sol fld vol > 999cc   Dialysate solution, any concentration of dextrose, fluid volu
   A4722          No Change       Dialys sol fld vol > 1999cc    Dialysate solution, any concentration of dextrose, fluid volu
   A4723          No Change       Dialys sol fld vol > 2999cc    Dialysate solution, any concentration of dextrose, fluid volu
   A4724          No Change       Dialys sol fld vol > 3999cc    Dialysate solution, any concentration of dextrose, fluid volu
   A4725          No Change       Dialys sol fld vol > 4999cc    Dialysate solution, any concentration of dextrose, fluid volu
   A4726          No Change       Dialys sol fld vol > 5999cc    Dialysate solution, any concentration of dextrose, fluid volu
   A4728          No Change       Dialysate solution, non-dex    Dialysate solution, non-dextrose containing, 500 ml
   A4730          No Change       Fistula cannulation set, ea    Fistula cannulation set for hemodialysis, each
   A4736          No Change       Topical anesthetic, per gram   Topical anesthetic, for dialysis, per gram
   A4737          No Change       Inj anesthetic per 10 ml       Injectable anesthetic, for dialysis, per 10 ml
   A4740          No Change       Shunt accessory                Shunt accessory, for hemodialysis, any type, each
   A4750          No Change       Art or venous blood tubing     Blood tubing, arterial or venous, for hemodialysis, each
   A4755          No Change       Comb art/venous blood tubing   Blood tubing, arterial and venous combined, for hemodialysis,
   A4760          No Change       Dialysate sol test kit, each   Dialysate solution test kit, for peritoneal dialysis, any typ
   A4765          No Change       Dialysate conc pow per pack    Dialysate concentrate, powder, additive for peritoneal dialys
   A4766          No Change       Dialysate conc sol add 10 ml   Dialysate concentrate, solution, additive for peritoneal dial
   A4770          No Change       Blood collection tube/vacuum   Blood collection tube, vacuum, for dialysis, per 50
   A4771          No Change       Serum clotting time tube       Serum clotting time tube, for dialysis, per 50
   A4772          No Change       Blood glucose test strips      Blood glucose test strips, for dialysis, per 50
   A4773          No Change       Occult blood test strips       Occult blood test strips, for dialysis, per 50
   A4774          No Change       Ammonia test strips            Ammonia test strips, for dialysis, per 50
   A4802          No Change       Protamine sulfate per 50 mg    Protamine sulfate, for hemodialysis, per 50 mg
   A4860          No Change       Disposable catheter tips       Disposable catheter tips for peritoneal dialysis, per 10
   A4870          No Change       Plumb/elec wk hm hemo equip    Plumbing and/or electrical work for home hemodialysis equipme
   A4890          No Change       Repair/maint cont hemo equip   Contracts, repair and maintenance, for hemodialysis equipment
   A4911          No Change       Drain bag/bottle               Drain bag/bottle, for dialysis, each
   A4913          No Change       Misc dialysis supplies noc     Miscellaneous dialysis supplies, not otherwise specified
   A4918          No Change       Venous pressure clamp          Venous pressure clamp, for hemodialysis, each
   A4927          No Change       Non-sterile gloves             Gloves, non-sterile, per 100
   A4928          No Change       Surgical mask                  Surgical mask, per 20
   A4929          No Change       Tourniquet for dialysis, ea    Tourniquet for dialysis, each
   A4930          No Change       Sterile, gloves per pair       Gloves, sterile, per pair
   A4931          No Change       Reusable oral thermometer      Oral thermometer, reusable, any type, each
   A4932          No Change       Reusable rectal thermometer    Rectal thermometer, reusable, any type, each
   A5051          No Change       Pouch clsd w barr attached     Ostomy pouch, closed; with barrier attached (1 piece), each
   A5052          No Change       Clsd ostomy pouch w/o barr     Ostomy pouch, closed; without barrier attached (1 piece), eac
   A5053          No Change       Clsd ostomy pouch faceplate    Ostomy pouch, closed; for use on faceplate, each
   A5054          No Change       Clsd ostomy pouch w/flange     Ostomy pouch, closed; for use on barrier with flange (2 piece
   A5055          No Change       Stoma cap                      Stoma cap
   A5056          No Change       1 pc ost pouch w filter        Ostomy pouch, drainable, with extended wear barrier attached,
   A5057          No Change       1 pc ost pou w built-in conv   Ostomy pouch, drainable, with extended wear barrier attached,
   A5061          No Change       Pouch drainable w barrier at   Ostomy pouch, drainable; with barrier attached, (1 piece), ea
   A5062          No Change       Drnble ostomy pouch w/o barr   Ostomy pouch, drainable; without barrier attached (1 piece),
   A5063          No Change       Drain ostomy pouch w/flange    Ostomy pouch, drainable; for use on barrier with flange (2 pi
   A5071          No Change       Urinary pouch w/barrier        Ostomy pouch, urinary; with barrier attached (1 piece), each
   A5072          No Change       Urinary pouch w/o barrier      Ostomy pouch, urinary; without barrier attached (1 piece), ea
   A5073          No Change       Urinary pouch on barr w/flng   Ostomy pouch, urinary; for use on barrier with flange (2 piec
   A5081          No Change       Stoma plug or seal, any type   Stoma plug or seal, any type
   A5082          No Change       Continent stoma catheter       Continent device; catheter for continent stoma
   A5083          No Change       Stoma absorptive cover         Continent device, stoma absorptive cover for continent stoma
   A5093          No Change       Ostomy accessory convex inse   Ostomy accessory; convex insert
   A5102          No Change       Bedside drain btl w/wo tube    Bedside drainage bottle with or without tubing, rigid or expa
   A5105          No Change       Urinary suspensory             Urinary suspensory with leg bag, with or without tube, each
   A5112          No Change       Urinary leg bag                Urinary drainage bag, leg or abdomen, latex, with or without
   A5113          No Change       Latex leg strap                Leg strap; latex, replacement only, per set
   A5114          No Change       Foam/fabric leg strap          Leg strap; foam or fabric, replacement only, per set
   A5120          No Change       Skin barrier, wipe or swab     Skin barrier, wipes or swabs, each
   A5121          No Change       Solid skin barrier 6x6         Skin barrier; solid, 6 x 6 or equivalent, each
   A5122          No Change       Solid skin barrier 8x8         Skin barrier; solid, 8 x 8 or equivalent, each
   A5126          No Change       Disk/foam pad +or- adhesive    Adhesive or non-adhesive; disk or foam pad
   A5131          No Change       Appliance cleaner              Appliance cleaner, incontinence and ostomy appliances, per 16
   A5200          No Change       Percutaneous catheter anchor   Percutaneous catheter/tube anchoring device, adhesive skin at
   A5500          No Change       Diab shoe for density insert   For diabetics only, fitting (including follow-up), custom pre
   A5501          No Change       Diabetic custom molded shoe    For diabetics only, fitting (including follow-up), custom pre
   A5503          No Change       Diabetic shoe w/roller/rockr   For diabetics only, modification (including fitting) of off-t
   A5504          No Change       Diabetic shoe with wedge       For diabetics only, modification (including fitting) of off-t
   A5505          No Change       Diab shoe w/metatarsal bar     For diabetics only, modification (including fitting) of off-t
   A5506          No Change       Diabetic shoe w/off set heel   For diabetics only, modification (including fitting) of off-t
   A5507          No Change       Modification diabetic shoe     For diabetics only, not otherwise specified modification (inc
   A5508          No Change       Diabetic deluxe shoe           For diabetics only, deluxe feature of off-the-shelf depth-inl
   A5510          No Change       Compression form shoe insert   For diabetics only, direct formed, compression molded to pati
   A6000          No Change       Wound warming wound cover      Non-contact wound warming wound cover for use with the non-co
   A6010          No Change       Collagen based wound filler    Collagen based wound filler, dry form, sterile, per gram of c
   A6011          No Change       Collagen gel/paste wound fil   Collagen based wound filler, gel/paste, per gram of collagen
   A6021          No Change       Collagen dressing <=16 sq in   Collagen dressing, sterile, size 16 sq. in. or less, each
   A6022          No Change       Collagen drsg>16<=48 sq in     Collagen dressing, sterile, size more than 16 sq. in. but les
   A6023          No Change       Collagen dressing >48 sq in    Collagen dressing, sterile, size more than 48 sq. in., each
   A6024          No Change       Collagen dsg wound filler      Collagen dressing wound filler, sterile, per 6 inches
   A6025          No Change       Silicone gel sheet, each       Gel sheet for dermal or epidermal application, (e.g., silicon
   A6154          No Change       Wound pouch each               Wound pouch, each
   A6196          No Change       Alginate dressing <=16 sq in   Alginate or other fiber gelling dressing, wound cover, steril
   A6197          No Change       Alginate drsg >16 <=48 sq in   Alginate or other fiber gelling dressing, wound cover, steril
   A6198          No Change       Alginate dressing > 48 sq in   Alginate or other fiber gelling dressing, wound cover, steril
   A6199          No Change       Alginate drsg wound filler     Alginate or other fiber gelling dressing, wound filler, steri
   A6203          No Change       Composite drsg <= 16 sq in     Composite dressing, sterile, pad size 16 sq. in. or less, wit
   A6204          No Change       Composite drsg >16<=48 sq in   Composite dressing, sterile, pad size more than 16 sq. in. bu
   A6205          No Change       Composite drsg > 48 sq in      Composite dressing, sterile, pad size more than 48 sq. in., w
   A6206          No Change       Contact layer <= 16 sq in      Contact layer, sterile, 16 sq. in. or less, each dressing
   A6207          No Change       Contact layer >16<= 48 sq in   Contact layer, sterile, more than 16 sq. in. but less than or
   A6208          No Change       Contact layer > 48 sq in       Contact layer, sterile, more than 48 sq. in., each dressing
   A6209          No Change       Foam drsg <=16 sq in w/o bdr   Foam dressing, wound cover, sterile, pad size 16 sq. in. or l
   A6210          No Change       Foam drg >16<=48 sq in w/o b   Foam dressing, wound cover, sterile, pad size more than 16 sq
   A6211          No Change       Foam drg > 48 sq in w/o brdr   Foam dressing, wound cover, sterile, pad size more than 48 sq
   A6212          No Change       Foam drg <=16 sq in w/border   Foam dressing, wound cover, sterile, pad size 16 sq. in. or l
   A6213          No Change       Foam drg >16<=48 sq in w/bdr   Foam dressing, wound cover, sterile, pad size more than 16 sq
   A6214          No Change       Foam drg > 48 sq in w/border   Foam dressing, wound cover, sterile, pad size more than 48 sq
   A6215          No Change       Foam dressing wound filler     Foam dressing, wound filler, sterile, per gram
   A6216          No Change       Non-sterile gauze<=16 sq in    Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or l
   A6217          No Change       Non-sterile gauze>16<=48 sq    Gauze, non-impregnated, non-sterile, pad size more than 16 sq
   A6218          No Change       Non-sterile gauze > 48 sq in   Gauze, non-impregnated, non-sterile, pad size more than 48 sq
   A6219          No Change       Gauze <= 16 sq in w/border     Gauze, non-impregnated, sterile, pad size 16 sq. in. or less,
   A6220          No Change       Gauze >16 <=48 sq in w/bordr   Gauze, non-impregnated, sterile, pad size more than 16 sq. in
   A6221          No Change       Gauze > 48 sq in w/border      Gauze, non-impregnated, sterile, pad size more than 48 sq. in
   A6222          No Change       Gauze <=16 in no w/sal w/o b   Gauze, impregnated with other than water, normal saline, or h
   A6223          No Change       Gauze >16<=48 no w/sal w/o b   Gauze, impregnated with other than water, normal saline, or h
   A6224          No Change       Gauze > 48 in no w/sal w/o b   Gauze, impregnated with other than water, normal saline, or h
   A6228          No Change       Gauze <= 16 sq in water/sal    Gauze, impregnated, water or normal saline, sterile, pad size
   A6229          No Change       Gauze >16<=48 sq in watr/sal   Gauze, impregnated, water or normal saline, sterile, pad size
   A6230          No Change       Gauze > 48 sq in water/salne   Gauze, impregnated, water or normal saline, sterile, pad size
   A6231          No Change       Hydrogel dsg<=16 sq in         Gauze, impregnated, hydrogel, for direct wound contact, steri
   A6232          No Change       Hydrogel dsg>16<=48 sq in      Gauze, impregnated, hydrogel, for direct wound contact, steri
   A6233          No Change       Hydrogel dressing >48 sq in    Gauze, impregnated, hydrogel, for direct wound contact, steri
   A6234          No Change       Hydrocolld drg <=16 w/o bdr    Hydrocolloid dressing, wound cover, sterile, pad size 16 sq.
   A6235          No Change       Hydrocolld drg >16<=48 w/o b   Hydrocolloid dressing, wound cover, sterile, pad size more th
   A6236          No Change       Hydrocolld drg > 48 in w/o b   Hydrocolloid dressing, wound cover, sterile, pad size more th
   A6237          No Change       Hydrocolld drg <=16 in w/bdr   Hydrocolloid dressing, wound cover, sterile, pad size 16 sq.
   A6238          No Change       Hydrocolld drg >16<=48 w/bdr   Hydrocolloid dressing, wound cover, sterile, pad size more th
   A6239          No Change       Hydrocolld drg > 48 in w/bdr   Hydrocolloid dressing, wound cover, sterile, pad size more th
   A6240          No Change       Hydrocolld drg filler paste    Hydrocolloid dressing, wound filler, paste, sterile, per ounc
   A6241          No Change       Hydrocolloid drg filler dry    Hydrocolloid dressing, wound filler, dry form, sterile, per g
   A6242          No Change       Hydrogel drg <=16 in w/o bdr   Hydrogel dressing, wound cover, sterile, pad size 16 sq. in.
   A6243          No Change       Hydrogel drg >16<=48 w/o bdr   Hydrogel dressing, wound cover, sterile, pad size more than 1
   A6244          No Change       Hydrogel drg >48 in w/o bdr    Hydrogel dressing, wound cover, sterile, pad size more than 4
   A6245          No Change       Hydrogel drg <= 16 in w/bdr    Hydrogel dressing, wound cover, sterile, pad size 16 sq. in.
   A6246          No Change       Hydrogel drg >16<=48 in w/b    Hydrogel dressing, wound cover, sterile, pad size more than 1
   A6247          No Change       Hydrogel drg > 48 sq in w/b    Hydrogel dressing, wound cover, sterile, pad size more than 4
   A6248          No Change       Hydrogel drsg gel filler       Hydrogel dressing, wound filler, gel, per fluid ounce
   A6250          No Change       Skin seal protect moisturizr   Skin sealants, protectants, moisturizers, ointments, any type
   A6251          No Change       Absorpt drg <=16 sq in w/o b   Specialty absorptive dressing, wound cover, sterile, pad size
   A6252          No Change       Absorpt drg >16 <=48 w/o bdr   Specialty absorptive dressing, wound cover, sterile, pad size
   A6253          No Change       Absorpt drg > 48 sq in w/o b   Specialty absorptive dressing, wound cover, sterile, pad size
   A6254          No Change       Absorpt drg <=16 sq in w/bdr   Specialty absorptive dressing, wound cover, sterile, pad size
   A6255          No Change       Absorpt drg >16<=48 in w/bdr   Specialty absorptive dressing, wound cover, sterile, pad size
   A6256          No Change       Absorpt drg > 48 sq in w/bdr   Specialty absorptive dressing, wound cover, sterile, pad size
   A6257          No Change       Transparent film <= 16 sq in   Transparent film, sterile, 16 sq. in. or less, each dressing
   A6258          No Change       Transparent film >16<=48 in    Transparent film, sterile, more than 16 sq. in. but less than
   A6259          No Change       Transparent film > 48 sq in    Transparent film, sterile, more than 48 sq. in., each dressin
   A6260          No Change       Wound cleanser any type/size   Wound cleansers, any type, any size
   A6261          No Change       Wound filler gel/paste /oz     Wound filler, gel/paste, per fluid ounce, not otherwise speci
   A6262          No Change       Wound filler dry form / gram   Wound filler, dry form, per gram, not otherwise specified
   A6266          No Change       Impreg gauze no h20/sal/yard   Gauze, impregnated, other than water, normal saline, or zinc
   A6402          No Change       Sterile gauze <= 16 sq in      Gauze, non-impregnated, sterile, pad size 16 sq. in. or less,
   A6403          No Change       Sterile gauze>16 <= 48 sq in   Gauze, non-impregnated, sterile, pad size more than 16 sq. in
   A6404          No Change       Sterile gauze > 48 sq in       Gauze, non-impregnated, sterile, pad size more than 48 sq. in
   A6407          No Change       Packing strips, non-impreg     Packing strips, non-impregnated, sterile, up to 2 inches in w
   A6410          No Change       Sterile eye pad                Eye pad, sterile, each
   A6411          No Change       Non-sterile eye pad            Eye pad, non-sterile, each
   A6412          No Change       Occlusive eye patch            Eye patch, occlusive, each
   A6413          No Change       Adhesive bandage, first-aid    Adhesive bandage, first-aid type, any size, each
   A6441          No Change       Pad band w>=3" <5"/yd          Padding bandage, non-elastic, non-woven/non-knitted, width gr
   A6442          No Change       Conform band n/s w<3"/yd       Conforming bandage, non-elastic, knitted/woven, non-sterile,
   A6443          No Change       Conform band n/s w>=3"<5"/yd   Conforming bandage, non-elastic, knitted/woven, non-sterile,
   A6444          No Change       Conform band n/s w>=5"/yd      Conforming bandage, non-elastic, knitted/woven, non-sterile,
   A6445          No Change       Conform band s w <3"/yd        Conforming bandage, non-elastic, knitted/woven, sterile, widt
   A6446          No Change       Conform band s w>=3" <5"/yd    Conforming bandage, non-elastic, knitted/woven, sterile, widt
   A6447          No Change       Conform band s w >=5"/yd       Conforming bandage, non-elastic, knitted/woven, sterile, widt
   A6448          No Change       Lt compres band <3"/yd         Light compression bandage, elastic, knitted/woven, width less
   A6449          No Change       Lt compres band >=3" <5"/yd    Light compression bandage, elastic, knitted/woven, width grea
   A6450          No Change       Lt compres band >=5"/yd        Light compression bandage, elastic, knitted/woven, width grea
   A6451          No Change       Mod compres band w>=3"<5"/yd   Moderate compression bandage, elastic, knitted/woven, load re
   A6452          No Change       High compres band w>=3"<5"yd   High compression bandage, elastic, knitted/woven, load resist
   A6453          No Change       Self-adher band w <3"/yd       Self-adherent bandage, elastic, non-knitted/non-woven, width
   A6454          No Change       Self-adher band w>=3" <5"/yd   Self-adherent bandage, elastic, non-knitted/non-woven, width
   A6455          No Change       Self-adher band >=5"/yd        Self-adherent bandage, elastic, non-knitted/non-woven, width
   A6456          No Change       Zinc paste band w >=3"<5"/yd   Zinc paste impregnated bandage, non-elastic, knitted/woven, w
   A6457          No Change       Tubular dressing               Tubular dressing with or without elastic, any width, per line
   A6501          No Change       Compres burngarment bodysuit   Compression burn garment, bodysuit (head to foot), custom fab
   A6502          No Change       Compres burngarment chinstrp   Compression burn garment, chin strap, custom fabricated
   A6503          No Change       Compres burngarment facehood   Compression burn garment, facial hood, custom fabricated
   A6504          No Change       Cmprsburngarment glove-wrist   Compression burn garment, glove to wrist, custom fabricated
   A6505          No Change       Cmprsburngarment glove-elbow   Compression burn garment, glove to elbow, custom fabricated
   A6506          No Change       Cmprsburngrmnt glove-axilla    Compression burn garment, glove to axilla, custom fabricated
   A6507          No Change       Cmprs burngarment foot-knee    Compression burn garment, foot to knee length, custom fabrica
   A6508          No Change       Cmprs burngarment foot-thigh   Compression burn garment, foot to thigh length, custom fabric
   A6509          No Change       Compres burn garment jacket    Compression burn garment, upper trunk to waist including arm
   A6510          No Change       Compres burn garment leotard   Compression burn garment, trunk, including arms down to leg o
   A6511          No Change       Compres burn garment panty     Compression burn garment, lower trunk including leg openings
   A6512          No Change       Compres burn garment, noc      Compression burn garment, not otherwise classified
   A6513          No Change       Compress burn mask face/neck   Compression burn mask, face and/or neck, plastic or equal, cu
   A6530          No Change       Compression stocking bk18-30   Gradient compression stocking, below knee, 18-30 mmhg, each
   A6531          No Change       Compression stocking bk30-40   Gradient compression stocking, below knee, 30-40 mmhg, each
   A6532          No Change       Compression stocking bk40-50   Gradient compression stocking, below knee, 40-50 mmhg, each
   A6533          No Change       Gc stocking thighlngth 18-30   Gradient compression stocking, thigh length, 18-30 mmhg, each
   A6534          No Change       Gc stocking thighlngth 30-40   Gradient compression stocking, thigh length, 30-40 mmhg, each
   A6535          No Change       Gc stocking thighlngth 40-50   Gradient compression stocking, thigh length, 40-50 mmhg, each
   A6536          No Change       Gc stocking full lngth 18-30   Gradient compression stocking, full length/chap style, 18-30
   A6537          No Change       Gc stocking full lngth 30-40   Gradient compression stocking, full length/chap style, 30-40
   A6538          No Change       Gc stocking full lngth 40-50   Gradient compression stocking, full length/chap style, 40-50
   A6539          No Change       Gc stocking waistlngth 18-30   Gradient compression stocking, waist length, 18-30 mmhg, each
   A6540          No Change       Gc stocking waistlngth 30-40   Gradient compression stocking, waist length, 30-40 mmhg, each
   A6541          No Change       Gc stocking waistlngth 40-50   Gradient compression stocking, waist length, 40-50 mmhg, each
   A6544          No Change       Gc stocking garter belt        Gradient compression stocking, garter belt
   A6545          No Change       Grad comp non-elastic bk       Gradient compression wrap, non-elastic, below knee, 30-50 mm
   A6549          No Change       G compression stocking         Gradient compression stocking/sleeve, not otherwise specified
   A6550          No Change       Neg pres wound ther drsg set   Wound care set, for negative pressure wound therapy electrica
   A7000          No Change       Disposable canister for pump   Canister, disposable, used with suction pump, each
   A7001          No Change       Nondisposable pump canister    Canister, non-disposable, used with suction pump, each
   A7002          No Change       Tubing used w suction pump     Tubing, used with suction pump, each
   A7003          No Change       Nebulizer administration set   Administration set, with small volume nonfiltered pneumatic n
   A7004          No Change       Disposable nebulizer sml vol   Small volume nonfiltered pneumatic nebulizer, disposable
   A7005          No Change       Nondisposable nebulizer set    Administration set, with small volume nonfiltered pneumatic n
   A7006          No Change       Filtered nebulizer admin set   Administration set, with small volume filtered pneumatic nebu
   A7007          No Change       Lg vol nebulizer disposable    Large volume nebulizer, disposable, unfilled, used with aeros
   A7008          No Change       Disposable nebulizer prefill   Large volume nebulizer, disposable, prefilled, used with aero
   A7009          No Change       Nebulizer reservoir bottle     Reservoir bottle, non-disposable, used with large volume ultr
   A7010          No Change       Disposable corrugated tubing   Corrugated tubing, disposable, used with large volume nebuliz
   A7011          No Change       Nondispos corrugated tubing    Corrugated tubing, non-disposable, used with large volume neb
   A7012          No Change       Nebulizer water collec devic   Water collection device, used with large volume nebulizer
   A7013          No Change       Disposable compressor filter   Filter, disposable, used with aerosol compressor or ultrasoni
   A7014          No Change       Compressor nondispos filter    Filter, nondisposable, used with aerosol compressor or ultras
   A7015          No Change       Aerosol mask used w nebulize   Aerosol mask, used with dme nebulizer
   A7016          No Change       Nebulizer dome & mouthpiece    Dome and mouthpiece, used with small volume ultrasonic nebuli
   A7017          No Change       Nebulizer not used w oxygen    Nebulizer, durable, glass or autoclavable plastic, bottle typ
   A7018          No Change       Water distilled w/nebulizer    Water, distilled, used with large volume nebulizer, 1000 ml
   A7020          No Change       Interface, cough stim device   Interface for cough stimulating device, includes all componen
   A7025          No Change       Replace chest compress vest    High frequency chest wall oscillation system vest, replacemen
   A7026          No Change       Replace chst cmprss sys hose   High frequency chest wall oscillation system hose, replacemen
   A7027          No Change       Combination oral/nasal mask    Combination oral/nasal mask, used with continuous positive ai
   A7028          No Change       Repl oral cushion combo mask   Oral cushion for combination oral/nasal mask, replacement onl
   A7029          No Change       Repl nasal pillow comb mask    Nasal pillows for combination oral/nasal mask, replacement on
   A7030          No Change       Cpap full face mask            Full face mask used with positive airway pressure device, eac
   A7031          No Change       Replacement facemask interfa   Face mask interface, replacement for full face mask, each
   A7032          No Change       Replacement nasal cushion      Cushion for use on nasal mask interface, replacement only, ea
   A7033          No Change       Replacement nasal pillows      Pillow for use on nasal cannula type interface, replacement o
   A7034          No Change       Nasal application device       Nasal interface (mask or cannula type) used with positive air
   A7035          No Change       Pos airway press headgear      Headgear used with positive airway pressure device
   A7036          No Change       Pos airway press chinstrap     Chinstrap used with positive airway pressure device
   A7037          No Change       Pos airway pressure tubing     Tubing used with positive airway pressure device
   A7038          No Change       Pos airway pressure filter     Filter, disposable, used with positive airway pressure device
   A7039          No Change       Filter, non disposable w pap   Filter, non disposable, used with positive airway pressure de
   A7040          No Change       One way chest drain valve      One way chest drain valve
   A7041          No Change       Water seal drain container     Water seal drainage container and tubing for use with implant
   A7042          No Change       Implanted pleural catheter     Implanted pleural catheter, each
   A7043          No Change       Vacuum drainagebottle/tubing   Vacuum drainage bottle and tubing for use with implanted cath
   A7044          No Change       Pap oral interface             Oral interface used with positive airway pressure device, eac
   A7045          No Change       Repl exhalation port for pap   Exhalation port with or without swivel used with accessories
   A7046          No Change       Repl water chamber, pap dev    Water chamber for humidifier, used with positive airway press
   A7047          No Change       Resp suction oral interface    Oral interface used with respiratory suction pump, each
   A7048          No Change       Vacuum drain bottle/tube kit   Vacuum drainage collection unit and tubing kit, including all
   A7501          No Change       Tracheostoma valve w diaphra   Tracheostoma valve, including diaphragm, each
   A7502          No Change       Replacement diaphragm/fplate   Replacement diaphragm/faceplate for tracheostoma valve, each
   A7503          No Change       Hmes filter holder or cap      Filter holder or filter cap, reusable, for use in a tracheost
   A7504          No Change       Tracheostoma hmes filter       Filter for use in a tracheostoma heat and moisture exchange s
   A7505          No Change       Hmes or trach valve housing    Housing, reusable without adhesive, for use in a heat and moi
   A7506          No Change       Hmes/trachvalve adhesivedisk   Adhesive disc for use in a heat and moisture exchange system
   A7507          No Change       Integrated filter & holder     Filter holder and integrated filter without adhesive, for use
   A7508          No Change       Housing & integrated adhesiv   Housing and integrated adhesive, for use in a tracheostoma he
   A7509          No Change       Heat & moisture exchange sys   Filter holder and integrated filter housing, and adhesive, fo
   A7520          No Change       Trach/laryn tube non-cuffed    Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride
   A7521          No Change       Trach/laryn tube cuffed        Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pv
   A7522          No Change       Trach/laryn tube stainless     Tracheostomy/laryngectomy tube, stainless steel or equal (ste
   A7523          No Change       Tracheostomy shower protect    Tracheostomy shower protector, each
   A7524          No Change       Tracheostoma stent/stud/bttn   Tracheostoma stent/stud/button, each
   A7525          No Change       Tracheostomy mask              Tracheostomy mask, each
   A7526          No Change       Tracheostomy tube collar       Tracheostomy tube collar/holder, each
   A7527          No Change       Trach/laryn tube plug/stop     Tracheostomy/laryngectomy tube plug/stop, each
   A8000          No Change       Soft protect helmet prefab     Helmet, protective, soft, prefabricated, includes all compone
   A8001          No Change       Hard protect helmet prefab     Helmet, protective, hard, prefabricated, includes all compone
   A8002          No Change       Soft protect helmet custom     Helmet, protective, soft, custom fabricated, includes all com
   A8003          No Change       Hard protect helmet custom     Helmet, protective, hard, custom fabricated, includes all com
   A8004          No Change       Repl soft interface, helmet    Soft interface for helmet, replacement only
   A9150          No Change       Misc/exper non-prescript dru   Non-prescription drugs
   A9152          No Change       Single vitamin nos             Single vitamin/mineral/trace element, oral, per dose, not oth
   A9153          No Change       Multi-vitamin nos              Multiple vitamins, with or without minerals and trace element
   A9155          No Change       Artificial saliva              Artificial saliva, 30 ml
   A9180          No Change       Lice treatment, topical        Pediculosis (lice infestation) treatment, topical, for admini
   A9270          No Change       Non-covered item or service    Non-covered item or service
   A9272          No Change       Disp wound suct, drsg/access   Wound suction, disposable, includes dressing, all accessories
   A9274          No Change       Ext amb insulin delivery sys   External ambulatory insulin delivery system, disposable, each
   A9275          No Change       Disp home glucose monitor      Home glucose disposable monitor, includes test strips
   A9276          No Change       Disposable sensor, cgm sys     Sensor; invasive (e.g., subcutaneous), disposable, for use wi
   A9277          No Change       External transmitter, cgm      Transmitter; external, for use with interstitial continuous g
   A9278          No Change       External receiver, cgm sys     Receiver (monitor); external, for use with interstitial conti
   A9279          No Change       Monitoring feature/devicenoc   Monitoring feature/device, stand-alone or integrated, any typ
   A9280          No Change       Alert device, noc              Alert or alarm device, not otherwise classified
   A9281          No Change       Reaching/grabbing device       Reaching/grabbing device, any type, any length, each
   A9282          No Change       Wig any type                   Wig, any type, each
   A9283          No Change       Foot press off load supp dev   Foot pressure off loading/supportive device, any type, each
   A9284          No Change       Non-electronic spirometer      Spirometer, non-electronic, includes all accessories
   A9285          No Change       Inversion eversion cor devic   Inversion/eversion correction device
   A9286          No Change       Any hygienic item, device      Hygienic item or device, disposable or non-disposable, any ty
   A9300          No Change       Exercise equipment             Exercise equipment
   A9500          No Change       Tc99m sestamibi                Technetium tc-99m sestamibi, diagnostic, per study dose
   A9501          No Change       Technetium tc-99m teboroxime   Technetium tc-99m teboroxime, diagnostic, per study dose
   A9502          No Change       Tc99m tetrofosmin              Technetium tc-99m tetrofosmin, diagnostic, per study dose
   A9503          No Change       Tc99m medronate                Technetium tc-99m medronate, diagnostic, per study dose, up t
   A9504          No Change       Tc99m apcitide                 Technetium tc-99m apcitide, diagnostic, per study dose, up to
   A9505          No Change       Tl201 thallium                 Thallium tl-201 thallous chloride, diagnostic, per millicurie
   A9507          No Change       In111 capromab                 Indium in-111 capromab pendetide, diagnostic, per study dose,
   A9508          No Change       I131 iodobenguate, dx          Iodine i-131 iobenguane sulfate, diagnostic, per 0.5 millicur
   A9509          No Change       Iodine i-123 sod iodide mil    Iodine i-123 sodium iodide, diagnostic, per millicurie
   A9510          No Change       Tc99m disofenin                Technetium tc-99m disofenin, diagnostic, per study dose, up t
   A9512          No Change       Tc99m pertechnetate            Technetium tc-99m pertechnetate, diagnostic, per millicurie
   A9516          No Change       Iodine i-123 sod iodide mic    Iodine i-123 sodium iodide, diagnostic, per 100 microcuries,
   A9517          No Change       I131 iodide cap, rx            Iodine i-131 sodium iodide capsule(s), therapeutic, per milli
   A9520          No Change       Tc99 tilmanocept diag 0.5mci   Technetium tc-99m tilmanocept, diagnostic, up to 0.5 millicur
   A9521          No Change       Tc99m exametazime              Technetium tc-99m exametazime, diagnostic, per study dose, up
   A9524          No Change       I131 serum albumin, dx         Iodine i-131 iodinated serum albumin, diagnostic, per 5 micro
   A9526          No Change       Nitrogen n-13 ammonia          Nitrogen n-13 ammonia, diagnostic, per study dose, up to 40 m
   A9527          No Change       Iodine i-125 sodium iodide     Iodine i-125, sodium iodide solution, therapeutic, per millic
   A9528          No Change       Iodine i-131 iodide cap, dx    Iodine i-131 sodium iodide capsule(s), diagnostic, per millic
   A9529          No Change       I131 iodide sol, dx            Iodine i-131 sodium iodide solution, diagnostic, per millicur
   A9530          No Change       I131 iodide sol, rx            Iodine i-131 sodium iodide solution, therapeutic, per millicu
   A9531          No Change       I131 max 100uci                Iodine i-131 sodium iodide, diagnostic, per microcurie (up to
   A9532          No Change       I125 serum albumin, dx         Iodine i-125 serum albumin, diagnostic, per 5 microcuries
   A9536          No Change       Tc99m depreotide               Technetium tc-99m depreotide, diagnostic, per study dose, up
   A9537          No Change       Tc99m mebrofenin               Technetium tc-99m mebrofenin, diagnostic, per study dose, up
   A9538          No Change       Tc99m pyrophosphate            Technetium tc-99m pyrophosphate, diagnostic, per study dose,
   A9539          No Change       Tc99m pentetate                Technetium tc-99m pentetate, diagnostic, per study dose, up t
   A9540          No Change       Tc99m maa                      Technetium tc-99m macroaggregated albumin, diagnostic, per st
   A9541          No Change       Tc99m sulfur colloid           Technetium tc-99m sulfur colloid, diagnostic, per study dose,
   A9542          No Change       In111 ibritumomab, dx          Indium in-111 ibritumomab tiuxetan, diagnostic, per study dos
   A9543          No Change       Y90 ibritumomab, rx            Yttrium y-90 ibritumomab tiuxetan, therapeutic, per treatment
   A9544          No Change       I131 tositumomab, dx           Iodine i-131 tositumomab, diagnostic, per study dose
   A9545          No Change       I131 tositumomab, rx           Iodine i-131 tositumomab, therapeutic, per treatment dose
   A9546          No Change       Co57/58                        Cobalt co-57/58, cyanocobalamin, diagnostic, per study dose,
   A9547          No Change       In111 oxyquinoline             Indium in-111 oxyquinoline, diagnostic, per 0.5 millicurie
   A9548          No Change       In111 pentetate                Indium in-111 pentetate, diagnostic, per 0.5 millicurie
   A9550          No Change       Tc99m gluceptate               Technetium tc-99m sodium gluceptate, diagnostic, per study do
   A9551          No Change       Tc99m succimer                 Technetium tc-99m succimer, diagnostic, per study dose, up to
   A9552          No Change       F18 fdg                        Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up t
   A9553          No Change       Cr51 chromate                  Chromium cr-51 sodium chromate, diagnostic, per study dose, u
   A9554          No Change       I125 iothalamate, dx           Iodine i-125 sodium iothalamate, diagnostic, per study dose,
   A9555          No Change       Rb82 rubidium                  Rubidium rb-82, diagnostic, per study dose, up to 60 millicur
   A9556          No Change       Ga67 gallium                   Gallium ga-67 citrate, diagnostic, per millicurie
   A9557          No Change       Tc99m bicisate                 Technetium tc-99m bicisate, diagnostic, per study dose, up to
   A9558          No Change       Xe133 xenon 10mci              Xenon xe-133 gas, diagnostic, per 10 millicuries
   A9559          No Change       Co57 cyano                     Cobalt co-57 cyanocobalamin, oral, diagnostic, per study dose
   A9560          No Change       Tc99m labeled rbc              Technetium tc-99m labeled red blood cells, diagnostic, per st
   A9561          No Change       Tc99m oxidronate               Technetium tc-99m oxidronate, diagnostic, per study dose, up
   A9562          No Change       Tc99m mertiatide               Technetium tc-99m mertiatide, diagnostic, per study dose, up
   A9563          No Change       P32 na phosphate               Sodium phosphate p-32, therapeutic, per millicurie
   A9564          No Change       P32 chromic phosphate          Chromic phosphate p-32 suspension, therapeutic, per millicuri
   A9566          No Change       Tc99m fanolesomab              Technetium tc-99m fanolesomab, diagnostic, per study dose, up
   A9567          No Change       Technetium tc-99m aerosol      Technetium tc-99m pentetate, diagnostic, aerosol, per study d
   A9568          No Change       Technetium tc99m arcitumomab   Technetium tc-99m arcitumomab, diagnostic, per study dose, up
   A9569          No Change       Technetium tc-99m auto wbc     Technetium tc-99m exametazime labeled autologous white blood
   A9570          No Change       Indium in-111 auto wbc         Indium in-111 labeled autologous white blood cells, diagnosti
   A9571          No Change       Indium in-111 auto platelet    Indium in-111 labeled autologous platelets, diagnostic, per s
   A9572          No Change       Indium in-111 pentetreotide    Indium in-111 pentetreotide, diagnostic, per study dose, up t
   A9575          No Change       Inj gadoterate meglumi 0.1ml   Injection, gadoterate meglumine, 0.1 ml
   A9576          No Change       Inj prohance multipack         Injection, gadoteridol, (prohance multipack), per ml
   A9577          No Change       Inj multihance                 Injection, gadobenate dimeglumine (multihance), per ml
   A9578          No Change       Inj multihance multipack       Injection, gadobenate dimeglumine (multihance multipack), per
   A9579          No Change       Gad-base mr contrast nos,1ml   Injection, gadolinium-based magnetic resonance contrast agent
   A9580          No Change       Sodium fluoride f-18           Sodium fluoride f-18, diagnostic, per study dose, up to 30 mi
   A9581          No Change       Gadoxetate disodium inj        Injection, gadoxetate disodium, 1 ml
   A9582          No Change       Iodine i-123 iobenguane        Iodine i-123 iobenguane, diagnostic, per study dose, up to 15
   A9583          No Change       Gadofosveset trisodium inj     Injection, gadofosveset trisodium, 1 ml
   A9584          No Change       Iodine i-123 ioflupane         Iodine 1-123 ioflupane, diagnostic, per study dose, up to 5 m
   A9585          No Change       Gadobutrol injection           Injection, gadobutrol, 0.1 ml
   A9587          No Change       Gallium ga-68                  Gallium ga-68, dotatate, diagnostic, 0.1 millicurie
   A9588          No Change       Fluciclovine f-18              Fluciclovine f-18, diagnostic, 1 millicurie
   A9597          No Change       Pet, dx, for tumor id, noc     Positron emission tomography radiopharmaceutical, diagnostic,
   A9598          No Change       Pet dx for non-tumor id, noc   Positron emission tomography radiopharmaceutical, diagnostic,
   A9599          No Change       Radioph dx b amyloid pet nos   Radiopharmaceutical, diagnostic, for beta-amyloid positron em
   A9600          No Change       Sr89 strontium                 Strontium sr-89 chloride, therapeutic, per millicurie
   A9604          No Change       Sm 153 lexidronam              Samarium sm-153 lexidronam, therapeutic, per treatment dose,
   A9606          No Change       Radium ra223 dichloride ther   Radium ra-223 dichloride, therapeutic, per microcurie
   A9698          No Change       Non-rad contrast materialnoc   Non-radioactive contrast imaging material, not otherwise clas
   A9699          No Change       Radiopharm rx agent noc        Radiopharmaceutical, therapeutic, not otherwise classified
   A9700          No Change       Echocardiography contrast      Supply of injectable contrast material for use in echocardiog
   A9900          No Change       Supply/accessory/service       Miscellaneous dme supply, accessory, and/or service component
   A9901          No Change       Delivery/set up/dispensing     Dme delivery, set up, and/or dispensing service component of
   A9999          No Change       Dme supply or accessory, nos   Miscellaneous dme supply or accessory, not otherwise specifie
   B4034          No Change       Enter feed supkit syr by day   Enteral feeding supply kit; syringe fed, per day, includes bu
   B4035          No Change       Enteral feed supp pump per d   Enteral feeding supply kit; pump fed, per day, includes but n
   B4036          No Change       Enteral feed sup kit grav by   Enteral feeding supply kit; gravity fed, per day, includes bu
   B4081          No Change       Enteral ng tubing w/ stylet    Nasogastric tubing with stylet
   B4082          No Change       Enteral ng tubing w/o stylet   Nasogastric tubing without stylet
   B4083          No Change       Enteral stomach tube levine    Stomach tube - levine type
   B4087          No Change       Gastro/jejuno tube, std        Gastrostomy/jejunostomy tube, standard, any material, any typ
   B4088          No Change       Gastro/jejuno tube, low-pro    Gastrostomy/jejunostomy tube, low-profile, any material, any
   B4100          No Change       Food thickener oral            Food thickener, administered orally, per ounce
   B4102          No Change       Ef adult fluids and electro    Enteral formula, for adults, used to replace fluids and elect
   B4103          No Change       Ef ped fluid and electrolyte   Enteral formula, for pediatrics, used to replace fluids and e
   B4104          No Change       Additive for enteral formula   Additive for enteral formula (e.g., fiber)
   B4149          No Change       Ef blenderized foods           Enteral formula, manufactured blenderized natural foods with
   B4150          No Change       Ef complet w/intact nutrient   Enteral formula, nutritionally complete with intact nutrients
   B4152          No Change       Ef calorie dense>/=1.5kcal     Enteral formula, nutritionally complete, calorically dense (e
   B4153          No Change       Ef hydrolyzed/amino acids      Enteral formula, nutritionally complete, hydrolyzed proteins
   B4154          No Change       Ef spec metabolic noninherit   Enteral formula, nutritionally complete, for special metaboli
   B4155          No Change       Ef incomplete/modular          Enteral formula, nutritionally incomplete/modular nutrients,
   B4157          No Change       Ef special metabolic inherit   Enteral formula, nutritionally complete, for special metaboli
   B4158          No Change       Ef ped complete intact nut     Enteral formula, for pediatrics, nutritionally complete with
   B4159          No Change       Ef ped complete soy based      Enteral formula, for pediatrics, nutritionally complete soy b
   B4160          No Change       Ef ped caloric dense>/=0.7kc   Enteral formula, for pediatrics, nutritionally complete calor
   B4161          No Change       Ef ped hydrolyzed/amino acid   Enteral formula, for pediatrics, hydrolyzed/amino acids and p
   B4162          No Change       Ef ped specmetabolic inherit   Enteral formula, for pediatrics, special metabolic needs for
   B4164          No Change       Parenteral 50% dextrose solu   Parenteral nutrition solution: carbohydrates (dextrose), 50%
   B4168          No Change       Parenteral sol amino acid 3.   Parenteral nutrition solution; amino acid, 3.5%, (500 ml = 1
   B4172          No Change       Parenteral sol amino acid 5.   Parenteral nutrition solution; amino acid, 5.5% through 7%, (
   B4176          No Change       Parenteral sol amino acid 7-   Parenteral nutrition solution; amino acid, 7% through 8.5%, (
   B4178          No Change       Parenteral sol amino acid >    Parenteral nutrition solution: amino acid, greater than 8.5%
   B4180          No Change       Parenteral sol carb > 50%      Parenteral nutrition solution; carbohydrates (dextrose), grea
   B4185          No Change       Parenteral sol 10 gm lipids    Parenteral nutrition solution, per 10 grams lipids
   B4189          No Change       Parenteral sol amino acid &    Parenteral nutrition solution; compounded amino acid and carb
   B4193          No Change       Parenteral sol 52-73 gm prot   Parenteral nutrition solution; compounded amino acid and carb
   B4197          No Change       Parenteral sol 74-100 gm pro   Parenteral nutrition solution; compounded amino acid and carb
   B4199          No Change       Parenteral sol > 100gm prote   Parenteral nutrition solution; compounded amino acid and carb
   B4216          No Change       Parenteral nutrition additiv   Parenteral nutrition; additives (vitamins, trace elements, he
   B4220          No Change       Parenteral supply kit premix   Parenteral nutrition supply kit; premix, per day
   B4222          No Change       Parenteral supply kit homemi   Parenteral nutrition supply kit; home mix, per day
   B4224          No Change       Parenteral administration ki   Parenteral nutrition administration kit, per day
   B5000          No Change       Parenteral sol renal-amirosy   Parenteral nutrition solution compounded amino acid and carbo
   B5100          No Change       Parenteral solution hepatic    Parenteral nutrition solution compounded amino acid and carbo
   B5200          No Change       Parenteral sol hepatic fream   Parenteral nutrition solution compounded amino acid and carbo
   B9000          No Change       Enter infusion pump w/o alrm   Enteral nutrition infusion pump - without alarm
   B9002          No Change       Enter nutr inf pump any type   Enteral nutrition infusion pump, any type
   B9004          No Change       Parenteral infus pump portab   Parenteral nutrition infusion pump, portable
   B9006          No Change       Parenteral infus pump statio   Parenteral nutrition infusion pump, stationary
   B9998          No Change       Enteral supp not otherwise c   Noc for enteral supplies
   B9999          No Change       Parenteral supp not othrws c   Noc for parenteral supplies
   C1300          No Change       Hyperbaric oxygen              Hyperbaric oxygen under pressure, full body chamber, per 30 m
   C1713          No Change       Anchor/screw bn/bn,tis/bn      Anchor/screw for opposing bone-to-bone or soft tissue-to-bone
   C1714          No Change       Cath, trans atherectomy, dir   Catheter, transluminal atherectomy, directional
   C1715          No Change       Brachytherapy needle           Brachytherapy needle
   C1716          No Change       Brachytx, non-str, gold-198    Brachytherapy source, non-stranded, gold-198, per source
   C1717          No Change       Brachytx, non-str,hdr ir-192   Brachytherapy source, non-stranded, high dose rate iridium-19
   C1719          No Change       Brachytx, ns, non-hdrir-192    Brachytherapy source, non-stranded, non-high dose rate iridiu
   C1721          No Change       Aicd, dual chamber             Cardioverter-defibrillator, dual chamber (implantable)
   C1722          No Change       Aicd, single chamber           Cardioverter-defibrillator, single chamber (implantable)
   C1724          No Change       Cath, trans atherec,rotation   Catheter, transluminal atherectomy, rotational
   C1725          No Change       Cath, translumin non-laser     Catheter, transluminal angioplasty, non-laser (may include gu
   C1726          No Change       Cath, bal dil, non-vascular    Catheter, balloon dilatation, non-vascular
   C1727          No Change       Cath, bal tis dis, non-vas     Catheter, balloon tissue dissector, non-vascular (insertable)
   C1728          No Change       Cath, brachytx seed adm        Catheter, brachytherapy seed administration
   C1729          No Change       Cath, drainage                 Catheter, drainage
   C1730          No Change       Cath, ep, 19 or few elect      Catheter, electrophysiology, diagnostic, other than 3d mappin
   C1731          No Change       Cath, ep, 20 or more elec      Catheter, electrophysiology, diagnostic, other than 3d mappin
   C1732          No Change       Cath, ep, diag/abl, 3d/vect    Catheter, electrophysiology, diagnostic/ablation, 3d or vecto
   C1733          No Change       Cath, ep, othr than cool-tip   Catheter, electrophysiology, diagnostic/ablation, other than
   C1749          No Change       Endo, colon, retro imaging     Endoscope, retrograde imaging/illumination colonoscope device
   C1750          No Change       Cath, hemodialysis,long-term   Catheter, hemodialysis/peritoneal, long-term
   C1751          No Change       Cath, inf, per/cent/midline    Catheter, infusion, inserted peripherally, centrally or midli
   C1752          No Change       Cath,hemodialysis,short-term   Catheter, hemodialysis/peritoneal, short-term
   C1753          No Change       Cath, intravas ultrasound      Catheter, intravascular ultrasound
   C1754          No Change       Catheter, intradiscal          Catheter, intradiscal
   C1755          No Change       Catheter, intraspinal          Catheter, intraspinal
   C1756          No Change       Cath, pacing, transesoph       Catheter, pacing, transesophageal
   C1757          No Change       Cath, thrombectomy/embolect    Catheter, thrombectomy/embolectomy
   C1758          No Change       Catheter, ureteral             Catheter, ureteral
   C1759          No Change       Cath, intra echocardiography   Catheter, intracardiac echocardiography
   C1760          No Change       Closure dev, vasc              Closure device, vascular (implantable/insertable)
   C1762          No Change       Conn tiss, human(inc fascia)   Connective tissue, human (includes fascia lata)
   C1763          No Change       Conn tiss, non-human           Connective tissue, non-human (includes synthetic)
   C1764          No Change       Event recorder, cardiac        Event recorder, cardiac (implantable)
   C1765          No Change       Adhesion barrier               Adhesion barrier
   C1766          No Change       Intro/sheath,strble,non-peel   Introducer/sheath, guiding, intracardiac electrophysiological
   C1767          No Change       Generator, neuro non-recharg   Generator, neurostimulator (implantable), non-rechargeable
   C1768          No Change       Graft, vascular                Graft, vascular
   C1769          No Change       Guide wire                     Guide wire
   C1770          No Change       Imaging coil, mr, insertable   Imaging coil, magnetic resonance (insertable)
   C1771          No Change       Rep dev, urinary, w/sling      Repair device, urinary, incontinence, with sling graft
   C1772          No Change       Infusion pump, programmable    Infusion pump, programmable (implantable)
   C1773          No Change       Ret dev, insertable            Retrieval device, insertable (used to retrieve fractured medi
   C1776          No Change       Joint device (implantable)     Joint device (implantable)
   C1777          No Change       Lead, aicd, endo single coil   Lead, cardioverter-defibrillator, endocardial single coil (im
   C1778          No Change       Lead, neurostimulator          Lead, neurostimulator (implantable)
   C1779          No Change       Lead, pmkr, transvenous vdd    Lead, pacemaker, transvenous vdd single pass
   C1780          No Change       Lens, intraocular (new tech)   Lens, intraocular (new technology)
   C1781          No Change       Mesh (implantable)             Mesh (implantable)
   C1782          No Change       Morcellator                    Morcellator
   C1783          No Change       Ocular imp, aqueous drain de   Ocular implant, aqueous drainage assist device
   C1784          No Change       Ocular dev, intraop, det ret   Ocular device, intraoperative, detached retina
   C1785          No Change       Pmkr, dual, rate-resp          Pacemaker, dual chamber, rate-responsive (implantable)
   C1786          No Change       Pmkr, single, rate-resp        Pacemaker, single chamber, rate-responsive (implantable)
   C1787          No Change       Patient progr, neurostim       Patient programmer, neurostimulator
   C1788          No Change       Port, indwelling, imp          Port, indwelling (implantable)
   C1789          No Change       Prosthesis, breast, imp        Prosthesis, breast (implantable)
   C1813          No Change       Prosthesis, penile, inflatab   Prosthesis, penile, inflatable
   C1814          No Change       Retinal tamp, silicone oil     Retinal tamponade device, silicone oil
   C1815          No Change       Pros, urinary sph, imp         Prosthesis, urinary sphincter (implantable)
   C1816          No Change       Receiver/transmitter, neuro    Receiver and/or transmitter, neurostimulator (implantable)
   C1817          No Change       Septal defect imp sys          Septal defect implant system, intracardiac
   C1818          No Change       Integrated keratoprosthesis    Integrated keratoprosthesis
   C1819          No Change       Tissue localization-excision   Surgical tissue localization and excision device (implantable
   C1820          No Change       Generator neuro rechg bat sy   Generator, neurostimulator (implantable), with rechargeable b
   C1821          No Change       Interspinous implant           Interspinous process distraction device (implantable)
   C1822          No Change       Gen, neuro, hf, rechg bat      Generator, neurostimulator (implantable), high frequency, wit
   C1830          No Change       Power bone marrow bx needle    Powered bone marrow biopsy needle
   C1840          No Change       Telescopic intraocular lens    Lens, intraocular (telescopic)
   C1841          No Change       Retinal prosth int/ext comp    Retinal prosthesis, includes all internal and external compon
   C1842          No Change       Retinal prosth, add-on         Retinal prosthesis, includes all internal and external compon
   C1874          No Change       Stent, coated/cov w/del sys    Stent, coated/covered, with delivery system
   C1875          No Change       Stent, coated/cov w/o del sy   Stent, coated/covered, without delivery system
   C1876          No Change       Stent, non-coa/non-cov w/del   Stent, non-coated/non-covered, with delivery system
   C1877          No Change       Stent, non-coat/cov w/o del    Stent, non-coated/non-covered, without delivery system
   C1878          No Change       Matrl for vocal cord           Material for vocal cord medialization, synthetic (implantable
   C1880          No Change       Vena cava filter               Vena cava filter
   C1881          No Change       Dialysis access system         Dialysis access system (implantable)
   C1882          No Change       Aicd, other than sing/dual     Cardioverter-defibrillator, other than single or dual chamber
   C1883          No Change       Adapt/ext, pacing/neuro lead   Adapter/extension, pacing lead or neurostimulator lead (impla
   C1884          No Change       Embolization protect syst      Embolization protective system
   C1885          No Change       Cath, translumin angio laser   Catheter, transluminal angioplasty, laser
   C1886          No Change       Catheter, ablation             Catheter, extravascular tissue ablation, any modality (insert
   C1887          No Change       Catheter, guiding              Catheter, guiding (may include infusion/perfusion capability)
   C1888          No Change       Endovas non-cardiac abl cath   Catheter, ablation, non-cardiac, endovascular (implantable)
   C1891          No Change       Infusion pump,non-prog, perm   Infusion pump, non-programmable, permanent (implantable)
   C1892          No Change       Intro/sheath,fixed,peel-away   Introducer/sheath, guiding, intracardiac electrophysiological
   C1893          No Change       Intro/sheath, fixed,non-peel   Introducer/sheath, guiding, intracardiac electrophysiological
   C1894          No Change       Intro/sheath, non-laser        Introducer/sheath, other than guiding, other than intracardia
   C1895          No Change       Lead, aicd, endo dual coil     Lead, cardioverter-defibrillator, endocardial dual coil (impl
   C1896          No Change       Lead, aicd, non sing/dual      Lead, cardioverter-defibrillator, other than endocardial sing
   C1897          No Change       Lead, neurostim test kit       Lead, neurostimulator test kit (implantable)
   C1898          No Change       Lead, pmkr, other than trans   Lead, pacemaker, other than transvenous vdd single pass
   C1899          No Change       Lead, pmkr/aicd combination    Lead, pacemaker/cardioverter-defibrillator combination (impla
   C1900          No Change       Lead, coronary venous          Lead, left ventricular coronary venous system
   C2613          No Change       Lung bx plug w/del sys         Lung biopsy plug with delivery system
   C2614          No Change       Probe, perc lumb disc          Probe, percutaneous lumbar discectomy
   C2615          No Change       Sealant, pulmonary, liquid     Sealant, pulmonary, liquid
   C2616          No Change       Brachytx, non-str,yttrium-90   Brachytherapy source, non-stranded, yttrium-90, per source
   C2617          No Change       Stent, non-cor, tem w/o del    Stent, non-coronary, temporary, without delivery system
   C2618          No Change       Probe/needle, cryo             Probe/needle, cryoablation
   C2619          No Change       Pmkr, dual, non rate-resp      Pacemaker, dual chamber, non rate-responsive (implantable)
   C2620          No Change       Pmkr, single, non rate-resp    Pacemaker, single chamber, non rate-responsive (implantable)
   C2621          No Change       Pmkr, other than sing/dual     Pacemaker, other than single or dual chamber (implantable)
   C2622          No Change       Prosthesis, penile, non-inf    Prosthesis, penile, non-inflatable
   C2623          No Change       Cath, translumin, drug-coat    Catheter, transluminal angioplasty, drug-coated, non-laser
   C2624          No Change       Wireless pressure sensor       Implantable wireless pulmonary artery pressure sensor with de
   C2625          No Change       Stent, non-cor, tem w/del sy   Stent, non-coronary, temporary, with delivery system
   C2626          No Change       Infusion pump, non-prog,temp   Infusion pump, non-programmable, temporary (implantable)
   C2627          No Change       Cath, suprapubic/cystoscopic   Catheter, suprapubic/cystoscopic
   C2628          No Change       Catheter, occlusion            Catheter, occlusion
   C2629          No Change       Intro/sheath, laser            Introducer/sheath, other than guiding, other than intracardia
   C2630          No Change       Cath, ep, cool-tip             Catheter, electrophysiology, diagnostic/ablation, other than
   C2631          No Change       Rep dev, urinary, w/o sling    Repair device, urinary, incontinence, without sling graft
   C2634          No Change       Brachytx, non-str, ha, i-125   Brachytherapy source, non-stranded, high activity, iodine-125
   C2635          No Change       Brachytx, non-str, ha, p-103   Brachytherapy source, non-stranded, high activity, palladium-
   C2636          No Change       Brachy linear, non-str,p-103   Brachytherapy linear source, non-stranded, palladium-103, per
   C2637          No Change       Brachy,non-str,ytterbium-169   Brachytherapy source, non-stranded, ytterbium-169, per source
   C2638          No Change       Brachytx, stranded, i-125      Brachytherapy source, stranded, iodine-125, per source
   C2639          No Change       Brachytx, non-stranded,i-125   Brachytherapy source, non-stranded, iodine-125, per source
   C2640          No Change       Brachytx, stranded, p-103      Brachytherapy source, stranded, palladium-103, per source
   C2641          No Change       Brachytx, non-stranded,p-103   Brachytherapy source, non-stranded, palladium-103, per source
   C2642          No Change       Brachytx, stranded, c-131      Brachytherapy source, stranded, cesium-131, per source
   C2643          No Change       Brachytx, non-stranded,c-131   Brachytherapy source, non-stranded, cesium-131, per source
   C2645          No Change       Brachytx planar, p-103         Brachytherapy planar source, palladium-103, per square millim
   C2698          No Change       Brachytx, stranded, nos        Brachytherapy source, stranded, not otherwise specified, per
   C2699          No Change       Brachytx, non-stranded, nos    Brachytherapy source, non-stranded, not otherwise specified,
   C5271          No Change       Low cost skin substitute app   Application of low cost skin substitute graft to trunk, arms,
   C5272          No Change       Low cost skin substitute app   Application of low cost skin substitute graft to trunk, arms,
   C5273          No Change       Low cost skin substitute app   Application of low cost skin substitute graft to trunk, arms,
   C5274          No Change       Low cost skin substitute app   Application of low cost skin substitute graft to trunk, arms,
   C5275          No Change       Low cost skin substitute app   Application of low cost skin substitute graft to face, scalp,
   C5276          No Change       Low cost skin substitute app   Application of low cost skin substitute graft to face, scalp,
   C5277          No Change       Low cost skin substitute app   Application of low cost skin substitute graft to face, scalp,
   C5278          No Change       Low cost skin substitute app   Application of low cost skin substitute graft to face, scalp,
   C8900          No Change       Mra w/cont, abd                Magnetic resonance angiography with contrast, abdomen
   C8901          No Change       Mra w/o cont, abd              Magnetic resonance angiography without contrast, abdomen
   C8902          No Change       Mra w/o fol w/cont, abd        Magnetic resonance angiography without contrast followed by w
   C8903          No Change       Mri w/cont, breast,  uni       Magnetic resonance imaging with contrast, breast; unilateral
   C8905          No Change       Mri w/o fol w/cont, brst, un   Magnetic resonance imaging without contrast followed by with
   C8906          No Change       Mri w/cont, breast,  bi        Magnetic resonance imaging with contrast, breast; bilateral
   C8908          No Change       Mri w/o fol w/cont, breast,    Magnetic resonance imaging without contrast followed by with
   C8909          No Change       Mra w/cont, chest              Magnetic resonance angiography with contrast, chest (excludin
   C8910          No Change       Mra w/o cont, chest            Magnetic resonance angiography without contrast, chest (exclu
   C8911          No Change       Mra w/o fol w/cont, chest      Magnetic resonance angiography without contrast followed by w
   C8912          No Change       Mra w/cont, lwr ext            Magnetic resonance angiography with contrast, lower extremity
   C8913          No Change       Mra w/o cont, lwr ext          Magnetic resonance angiography without contrast, lower extrem
   C8914          No Change       Mra w/o fol w/cont, lwr ext    Magnetic resonance angiography without contrast followed by w
   C8918          No Change       Mra w/cont, pelvis             Magnetic resonance angiography with contrast, pelvis
   C8919          No Change       Mra w/o cont, pelvis           Magnetic resonance angiography without contrast, pelvis
   C8920          No Change       Mra w/o fol w/cont, pelvis     Magnetic resonance angiography without contrast followed by w
   C8921          No Change       Tte w or w/o fol w/cont, com   Transthoracic echocardiography with contrast, or without cont
   C8922          No Change       Tte w or w/o fol w/cont, f/u   Transthoracic echocardiography with contrast, or without cont
   C8923          No Change       2d tte w or w/o fol w/con,co   Transthoracic echocardiography with contrast, or without cont
   C8924          No Change       2d tte w or w/o fol w/con,fu   Transthoracic echocardiography with contrast, or without cont
   C8925          No Change       2d tee w or w/o fol w/con,in   Transesophageal echocardiography (tee) with contrast, or with
   C8926          No Change       Tee w or w/o fol w/cont,cong   Transesophageal echocardiography (tee) with contrast, or with
   C8927          No Change       Tee w or w/o fol w/cont, mon   Transesophageal echocardiography (tee) with contrast, or with
   C8928          No Change       Tte w or w/o fol w/con,stres   Transthoracic echocardiography with contrast, or without cont
   C8929          No Change       Tte w or wo fol wcon,doppler   Transthoracic echocardiography with contrast, or without cont
   C8930          No Change       Tte w or w/o contr, cont ecg   Transthoracic echocardiography, with contrast, or without con
   C8931          No Change       Mra, w/dye, spinal canal       Magnetic resonance angiography with contrast, spinal canal an
   C8932          No Change       Mra, w/o dye, spinal canal     Magnetic resonance angiography without contrast, spinal canal
   C8933          No Change       Mra, w/o&w/dye, spinal canal   Magnetic resonance angiography without contrast followed by w
   C8934          No Change       Mra, w/dye, upper extremity    Magnetic resonance angiography with contrast, upper extremity
   C8935          No Change       Mra, w/o dye, upper extr       Magnetic resonance angiography without contrast, upper extrem
   C8936          No Change       Mra, w/o&w/dye, upper extr     Magnetic resonance angiography without contrast followed by w
   C8957          No Change       Prolonged iv inf, req pump     Intravenous infusion for therapy/diagnosis; initiation of pro
   C9021          No Change       Injection, obinutuzumab        Injection, obinutuzumab, 10 mg
   C9022          No Change       Injection, elosulfase alfa     Injection, elosulfase alfa, 1mg
   C9023          No Change       Inj testosterone undecanoate   Injection, testosterone undecanoate, 1 mg
   C9025          No Change       Injection, ramucirumab         Injection, ramucirumab, 5 mg
   C9026          No Change       Injection, vedolizumab         Injection, vedolizumab, 1 mg
   C9027          No Change       Injection, pembrolizumab       Injection, pembrolizumab, 1 mg
   C9113          No Change       Inj pantoprazole sodium, via   Injection, pantoprazole sodium, per vial
   C9121          No Change       Injection, argatroban          Injection, argatroban, per 5 mg
   C9132          No Change       Kcentra, per i.u.              Prothrombin complex concentrate (human), kcentra, per i.u. of
   C9133          No Change       Factor ix recombinant          Factor ix (antihemophilic factor, recombinant), rixubis, per
   C9134          No Change       Factor xiii a-subunit recomb   Factor xiii (antihemophilic factor, recombinant), tretten, pe
   C9135          No Change       Factor ix (alprolix)           Factor ix (antihemophilic factor, recombinant), alprolix, per
   C9136          No Change       Factor viii (eloctate)         Injection, factor viii, fc fusion protein, (recombinant), per
   C9137          No Change       Adynovate factor viii recom    Injection, factor viii (antihemophilic factor, recombinant) p
   C9138          No Change       Nuwiq factor viii recomb       Injection, factor viii (antihemophilic factor, recombinant) (
   C9139          No Change       Idelvion, 1 i.u.               Injection, factor ix, albumin fusion protein (recombinant), i
   C9140          No Change       Afstyla factor viii recomb     Injection, factor viii (antihemophilic factor, recombinant) (
   C9250          No Change       Artiss fibrin sealant          Human plasma fibrin sealant, vapor-heated, solvent-detergent
   C9254          No Change       Injection, lacosamide          Injection, lacosamide, 1 mg
   C9257          No Change       Bevacizumab injection          Injection, bevacizumab, 0.25 mg
   C9285          No Change       Patch, lidocaine/tetracaine    Lidocaine 70 mg/tetracaine 70 mg, per patch
   C9293          No Change       Injection, glucarpidase        Injection, glucarpidase, 10 units
   C9349          No Change       Puraply, puraply antimic       Puraply, and puraply antimicrobial, any type, per square cent
   C9352          No Change       Neuragen nerve guide, per cm   Microporous collagen implantable tube (neuragen nerve guide),
   C9353          No Change       Neurawrap nerve protector,cm   Microporous collagen implantable slit tube (neurawrap nerve p
   C9354          No Change       Veritas collagen matrix, cm2   Acellular pericardial tissue matrix of non-human origin (veri
   C9355          No Change       Neuromatrix nerve cuff, cm     Collagen nerve cuff (neuromatrix), per 0.5 centimeter length
   C9356          No Change       Tenoglide tendon prot, cm2     Tendon, porous matrix of cross-linked collagen and glycosamin
   C9358          No Change       Surgimend, fetal               Dermal substitute, native, non-denatured collagen, fetal bovi
   C9359          No Change       Implnt,bon void filler-putty   Porous purified collagen matrix bone void filler (integra moz
   C9360          No Change       Surgimend, neonatal            Dermal substitute, native, non-denatured collagen, neonatal b
   C9361          No Change       Neuromend nerve wrap           Collagen matrix nerve wrap (neuromend collagen nerve wrap), p
   C9362          No Change       Implnt,bon void filler-strip   Porous purified collagen matrix bone void filler (integra moz
   C9363          No Change       Integra meshed bil wound mat   Skin substitute, integra meshed bilayer wound matrix, per squ
   C9364          No Change       Porcine implant, permacol      Porcine implant, permacol, per square centimeter
   C9399          No Change       Unclassified drugs or biolog   Unclassified drugs or biologicals
   C9441          No Change       Inj, ferric carboxymaltose     Injection, ferric carboxymaltose, 1 mg
   C9442          No Change       Injection, belinostat          Injection, belinostat, 10 mg
   C9443          No Change       Injection, dalbavancin         Injection, dalbavancin, 10 mg
   C9444          No Change       Injection, oritavancin         Injection, oritavancin, 10 mg
   C9445          No Change       C-1 esterase, ruconest         Injection, c-1 esterase inhibitor (recombinant), ruconest, 10
   C9446          No Change       Inj, tedizolid phosphate       Injection, tedizolid phosphate, 1 mg
   C9448          No Change       Oral netupitant palonosetron   Netupitant 300 mg and palonosetron 0.5 mg, oral
   C9449          No Change       Inj, blinatumomab              Injection, blinatumomab, 1 mcg
   C9450          No Change       Fluocinolone acetonide implt   Injection, fluocinolone acetonide intravitreal implant, 0.01
   C9451          No Change       Injection, peramivir           Injection, peramivir, 1 mg
   C9452          No Change       Inj, ceftolozane/tazobactam    Injection, ceftolozane 50 mg and tazobactam 25 mg
   C9453          No Change       Injection, nivolumab           Injection, nivolumab, 1 mg
   C9454          No Change       Inj, pasireotide long acting   Injection, pasireotide long acting, 1 mg
   C9455          No Change       Injection, siltuximab          Injection, siltuximab, 10 mg
   C9456          No Change       Inj, isavuconazonium sulfate   Injection, isavuconazonium sulfate, 1 mg
   C9457          No Change       Lumason contrast agent         Injection, sulfur hexafluoride lipid microsphere, per ml
   C9458          No Change       Florbetaben f18                Florbetaben f18, diagnostic, per study dose, up to 8.1 millic
   C9459          No Change       Flutemetamol f18               Flutemetamol f18, diagnostic, per study dose, up to 5 millicu
   C9460          No Change       Injection, cangrelor           Injection, cangrelor, 1 mg
   C9461          No Change       Choline c 11, diagnostic       Choline c 11, diagnostic, per study dose
   C9470          No Change       Aripiprazole lauroxil im       Injection, aripiprazole lauroxil, 1 mg
   C9471          No Change       Hymovis, 1 mg                  Hyaluronan or derivative, hymovis, for intra-articular inject
   C9472          No Change       Inj talimogene laherparepvec   Injection, talimogene laherparepvec, 1 million plaque forming
   C9473          No Change       Injection, mepolizumab         Injection, mepolizumab, 1 mg
   C9474          No Change       Inj, irinotecan liposome       Injection, irinotecan liposome, 1 mg
   C9475          No Change       Injection, necitumumab         Injection, necitumumab, 1 mg
   C9476          No Change       Injection, daratumumab         Injection, daratumumab, 10 mg
   C9477          No Change       Injection, elotuzumab          Injection, elotuzumab, 1 mg
   C9478          No Change       Injection, sebelipase alfa     Injection, sebelipase alfa, 1 mg
   C9479          No Change       Instill, ciprofloxacin otic    Instillation, ciprofloxacin otic suspension, 6 mg
   C9480          No Change       Injection, trabectedin         Injection, trabectedin, 0.1 mg
   C9481          No Change       Injection, reslizumab          Injection, reslizumab, 1 mg
   C9482          No Change       Sotalol hydrochloride iv       Injection, sotalol hydrochloride, 1 mg
   C9483          No Change       Injection, atezolizumab        Injection, atezolizumab, 10 mg
   C9484          No Change       Injection, eteplirsen          Injection, eteplirsen, 10 mg
   C9485          No Change       Injection, olaratumab          Injection, olaratumab, 10 mg
   C9486          No Change       Inj, granisetron ext           Injection, granisetron extended release, 0.1 mg
   C9487          No Change       Ustekinumab iv inj, 1 mg       Ustekinumab, for intravenous injection, 1 mg
   C9488          No Change       Conivaptan hcl                 Injection, conivaptan hydrochloride, 1 mg
   C9489          No Change       Injection, nusinersen          Injection, nusinersen, 0.1 mg
   C9490          No Change       Injection, bezlotoxumab        Injection, bezlotoxumab, 10 mg
   C9491          No Change       Injection, avelumab            Injection, avelumab, 10 mg
   C9494          No Change       Injection, ocrelizumab         Injection, ocrelizumab, 1 mg
   C9600          No Change       Perc drug-el cor stent sing    Percutaneous transcatheter placement of drug eluting intracor
   C9601          No Change       Perc drug-el cor stent bran    Percutaneous transcatheter placement of drug-eluting intracor
   C9602          No Change       Perc d-e cor stent ather s     Percutaneous transluminal coronary atherectomy, with drug elu
   C9603          No Change       Perc d-e cor stent ather br    Percutaneous transluminal coronary atherectomy, with drug-elu
   C9604          No Change       Perc d-e cor revasc t cabg s   Percutaneous transluminal revascularization of or through cor
   C9605          No Change       Perc d-e cor revasc t cabg b   Percutaneous transluminal revascularization of or through cor
   C9606          No Change       Perc d-e cor revasc w ami s    Percutaneous transluminal revascularization of acute total/su
   C9607          No Change       Perc d-e cor revasc chro sin   Percutaneous transluminal revascularization of chronic total
   C9608          No Change       Perc d-e cor revasc chro add   Percutaneous transluminal revascularization of chronic total
   C9724          No Change       Eps stomach plic               Endoscopic full-thickness plication of the stomach using endo
   C9725          No Change       Place endorectal app           Placement of endorectal intracavitary applicator for high int
   C9726          No Change       Rxt breast appl place/remov    Placement and removal (if performed) of applicator into breas
   C9727          No Change       Insert palate implants         Insertion of implants into the soft palate; minimum of three
   C9728          No Change       Place device/marker, non pro   Placement of interstitial device(s) for radiation therapy/sur
   C9733          No Change       Non-ophthalmic fva             Non-ophthalmic fluorescent vascular angiography
   C9734          No Change       U/s trtmt, not leiomyomata     Focused ultrasound ablation/therapeutic intervention, other t
   C9735          No Change       Anoscopy, submucosal inj       Anoscopy; with directed submucosal injection(s), any substanc
   C9737          No Change       Lap esoph augmentation         Laparoscopy, surgical, esophageal sphincter augmentation with
   C9738          No Change       Blue light cysto imag agent    Adjunctive blue light cystoscopy with fluorescent imaging age
   C9739          No Change       Cystoscopy prostatic imp 1-3   Cystourethroscopy, with insertion of transprostatic implant;
   C9740          No Change       Cysto impl 4 or more           Cystourethroscopy, with insertion of transprostatic implant;
   C9742          No Change       Laryngoscopy with injection    Laryngoscopy, flexible fiberoptic, with injection into vocal
   C9743          No Change       Bulking/spacer material impl   Injection/implantation of bulking or spacer material (any typ
   C9745          No Change       Nasal endo eustachian tube     Nasal endoscopy, surgical; balloon dilation of eustachian tub
   C9746          No Change       Trans imp balloon cont         Transperineal implantation of permanent adjustable balloon co
   C9747          No Change       Ablation, hifu, prostate       Ablation of prostate, transrectal, high intensity focused ult
   C9800          No Change       Dermal filler inj px/suppl     Dermal injection procedure(s) for facial lipodystrophy syndro
   C9898          No Change       Inpnt stay radiolabeled item   Radiolabeled product provided during a hospital inpatient sta
   C9899          No Change       Inpt implant pros dev,no cov   Implanted prosthetic device, payable only for inpatients who
   E0100          No Change       Cane adjust/fixed with tip     Cane, includes canes of all materials, adjustable or fixed, w
   E0105          No Change       Cane adjust/fixed quad/3 pro   Cane, quad or three prong, includes canes of all materials, a
   E0110          No Change       Crutch forearm pair            Crutches, forearm, includes crutches of various materials, ad
   E0111          No Change       Crutch forearm each            Crutch forearm, includes crutches of various materials, adjus
   E0112          No Change       Crutch underarm pair wood      Crutches underarm, wood, adjustable or fixed, pair, with pads
   E0113          No Change       Crutch underarm each wood      Crutch underarm, wood, adjustable or fixed, each, with pad, t
   E0114          No Change       Crutch underarm pair no wood   Crutches underarm, other than wood, adjustable or fixed, pair
   E0116          No Change       Crutch underarm each no wood   Crutch, underarm, other than wood, adjustable or fixed, with
   E0117          No Change       Underarm springassist crutch   Crutch, underarm, articulating, spring assisted, each
   E0118          No Change       Crutch substitute              Crutch substitute, lower leg platform, with or without wheels
   E0130          No Change       Walker rigid adjust/fixed ht   Walker, rigid (pickup), adjustable or fixed height
   E0135          No Change       Walker folding adjust/fixed    Walker, folding (pickup), adjustable or fixed height
   E0140          No Change       Walker w trunk support         Walker, with trunk support, adjustable or fixed height, any t
   E0141          No Change       Rigid wheeled walker adj/fix   Walker, rigid, wheeled, adjustable or fixed height
   E0143          No Change       Walker folding wheeled w/o s   Walker, folding, wheeled, adjustable or fixed height
   E0144          No Change       Enclosed walker w rear seat    Walker, enclosed, four sided framed, rigid or folding, wheele
   E0147          No Change       Walker variable wheel resist   Walker, heavy duty, multiple braking system, variable wheel r
   E0148          No Change       Heavyduty walker no wheels     Walker, heavy duty, without wheels, rigid or folding, any typ
   E0149          No Change       Heavy duty wheeled walker      Walker, heavy duty, wheeled, rigid or folding, any type
   E0153          No Change       Forearm crutch platform atta   Platform attachment, forearm crutch, each
   E0154          No Change       Walker platform attachment     Platform attachment, walker, each
   E0155          No Change       Walker wheel attachment,pair   Wheel attachment, rigid pick-up walker, per pair
   E0156          No Change       Walker seat attachment         Seat attachment, walker
   E0157          No Change       Walker crutch attachment       Crutch attachment, walker, each
   E0158          No Change       Walker leg extenders set of4   Leg extensions for walker, per set of four (4)
   E0159          No Change       Brake for wheeled walker       Brake attachment for wheeled walker, replacement, each
   E0160          No Change       Sitz type bath or equipment    Sitz type bath or equipment, portable, used with or without c
   E0161          No Change       Sitz bath/equipment w/faucet   Sitz type bath or equipment, portable, used with or without c
   E0162          No Change       Sitz bath chair                Sitz bath chair
   E0163          No Change       Commode chair with fixed arm   Commode chair, mobile or stationary, with fixed arms
   E0165          No Change       Commode chair with detacharm   Commode chair, mobile or stationary, with detachable arms
   E0167          No Change       Commode chair pail or pan      Pail or pan for use with commode chair, replacement only
   E0168          No Change       Heavyduty/wide commode chair   Commode chair, extra wide and/or heavy duty, stationary or mo
   E0170          No Change       Commode chair electric         Commode chair with integrated seat lift mechanism, electric,
   E0171          No Change       Commode chair non-electric     Commode chair with integrated seat lift mechanism, non-electr
   E0172          No Change       Seat lift mechanism toilet     Seat lift mechanism placed over or on top of toilet, any type
   E0175          No Change       Commode chair foot rest        Foot rest, for use with commode chair, each
   E0181          No Change       Press pad alternating w/ pum   Powered pressure reducing mattress overlay/pad, alternating,
   E0182          No Change       Replace pump, alt press pad    Pump for alternating pressure pad, for replacement only
   E0184          No Change       Dry pressure mattress          Dry pressure mattress
   E0185          No Change       Gel pressure mattress pad      Gel or gel-like pressure pad for mattress, standard mattress
   E0186          No Change       Air pressure mattress          Air pressure mattress
   E0187          No Change       Water pressure mattress        Water pressure mattress
   E0188          No Change       Synthetic sheepskin pad        Synthetic sheepskin pad
   E0189          No Change       Lambswool sheepskin pad        Lambswool sheepskin pad, any size
   E0190          No Change       Positioning cushion            Positioning cushion/pillow/wedge, any shape or size, includes
   E0191          No Change       Protector heel or elbow        Heel or elbow protector, each
   E0193          No Change       Powered air flotation bed      Powered air flotation bed (low air loss therapy)
   E0194          No Change       Air fluidized bed              Air fluidized bed
   E0196          No Change       Gel pressure mattress          Gel pressure mattress
   E0197          No Change       Air pressure pad for mattres   Air pressure pad for mattress, standard mattress length and w
   E0198          No Change       Water pressure pad for mattr   Water pressure pad for mattress, standard mattress length and
   E0199          No Change       Dry pressure pad for mattres   Dry pressure pad for mattress, standard mattress length and w
   E0200          No Change       Heat lamp without stand        Heat lamp, without stand (table model), includes bulb, or inf
   E0202          No Change       Phototherapy light w/ photom   Phototherapy (bilirubin) light with photometer
   E0203          No Change       Therapeutic lightbox tabletp   Therapeutic lightbox, minimum 10,000 lux, table top model
   E0205          No Change       Heat lamp with stand           Heat lamp, with stand, includes bulb, or infrared element
   E0210          No Change       Electric heat pad standard     Electric heat pad, standard
   E0215          No Change       Electric heat pad moist        Electric heat pad, moist
   E0217          No Change       Water circ heat pad w pump     Water circulating heat pad with pump
   E0221          No Change       Infrared heating pad system    Infrared heating pad system
   E0225          No Change       Hydrocollator unit             Hydrocollator unit, includes pads
   E0231          No Change       Wound warming device           Non-contact wound warming device (temperature control unit, a
   E0232          No Change       Warming card for nwt           Warming card for use with the non contact wound warming devic
   E0235          No Change       Paraffin bath unit portable    Paraffin bath unit, portable (see medical supply code a4265 f
   E0236          No Change       Pump for water circulating p   Pump for water circulating pad
   E0239          No Change       Hydrocollator unit portable    Hydrocollator unit, portable
   E0240          No Change       Bath/shower chair              Bath/shower chair, with or without wheels, any size
   E0241          No Change       Bath tub wall rail             Bath tub wall rail, each
   E0242          No Change       Bath tub rail floor            Bath tub rail, floor base
   E0243          No Change       Toilet rail                    Toilet rail, each
   E0244          No Change       Toilet seat raised             Raised toilet seat
   E0245          No Change       Tub stool or bench             Tub stool or bench
   E0246          No Change       Transfer tub rail attachment   Transfer tub rail attachment
   E0247          No Change       Trans bench w/wo comm open     Transfer bench for tub or toilet with or without commode open
   E0248          No Change       Hdtrans bench w/wo comm open   Transfer bench, heavy duty, for tub or toilet with or without
   E0249          No Change       Pad water circulating heat u   Pad for water circulating heat unit, for replacement only
   E0250          No Change       Hosp bed fixed ht w/ mattres   Hospital bed, fixed height, with any type side rails, with ma
   E0251          No Change       Hosp bed fixd ht w/o mattres   Hospital bed, fixed height, with any type side rails, without
   E0255          No Change       Hospital bed var ht w/ mattr   Hospital bed, variable height, hi-lo, with any type side rail
   E0256          No Change       Hospital bed var ht w/o matt   Hospital bed, variable height, hi-lo, with any type side rail
   E0260          No Change       Hosp bed semi-electr w/ matt   Hospital bed, semi-electric (head and foot adjustment), with
   E0261          No Change       Hosp bed semi-electr w/o mat   Hospital bed, semi-electric (head and foot adjustment), with
   E0265          No Change       Hosp bed total electr w/ mat   Hospital bed, total electric (head, foot and height adjustmen
   E0266          No Change       Hosp bed total elec w/o matt   Hospital bed, total electric (head, foot and height adjustmen
   E0270          No Change       Hospital bed institutional t   Hospital bed, institutional type includes: oscillating, circu
   E0271          No Change       Mattress innerspring           Mattress, innerspring
   E0272          No Change       Mattress foam rubber           Mattress, foam rubber
   E0273          No Change       Bed board                      Bed board
   E0274          No Change       Over-bed table                 Over-bed table
   E0275          No Change       Bed pan standard               Bed pan, standard, metal or plastic
   E0276          No Change       Bed pan fracture               Bed pan, fracture, metal or plastic
   E0277          No Change       Powered pres-redu air mattrs   Powered pressure-reducing air mattress
   E0280          No Change       Bed cradle                     Bed cradle, any type
   E0290          No Change       Hosp bed fx ht w/o rails w/m   Hospital bed, fixed height, without side rails, with mattress
   E0291          No Change       Hosp bed fx ht w/o rail w/o    Hospital bed, fixed height, without side rails, without mattr
   E0292          No Change       Hosp bed var ht no sr w/matt   Hospital bed, variable height, hi-lo, without side rails, wit
   E0293          No Change       Hosp bed var ht no sr no mat   Hospital bed, variable height, hi-lo, without side rails, wit
   E0294          No Change       Hosp bed semi-elect w/ mattr   Hospital bed, semi-electric (head and foot adjustment), witho
   E0295          No Change       Hosp bed semi-elect w/o matt   Hospital bed, semi-electric (head and foot adjustment), witho
   E0296          No Change       Hosp bed total elect w/ matt   Hospital bed, total electric (head, foot and height adjustmen
   E0297          No Change       Hosp bed total elect w/o mat   Hospital bed, total electric (head, foot and height adjustmen
   E0300          No Change       Enclosed ped crib hosp grade   Pediatric crib, hospital grade, fully enclosed, with or witho
   E0301          No Change       Hd hosp bed, 350-600 lbs       Hospital bed, heavy duty, extra wide, with weight capacity gr
   E0302          No Change       Ex hd hosp bed > 600 lbs       Hospital bed, extra heavy duty, extra wide, with weight capac
   E0303          No Change       Hosp bed hvy dty xtra wide     Hospital bed, heavy duty, extra wide, with weight capacity gr
   E0304          No Change       Hosp bed xtra hvy dty x wide   Hospital bed, extra heavy duty, extra wide, with weight capac
   E0305          No Change       Rails bed side half length     Bed side rails, half length
   E0310          No Change       Rails bed side full length     Bed side rails, full length
   E0315          No Change       Bed accessory brd/tbl/supprt   Bed accessory: board, table, or support device, any type
   E0316          No Change       Bed safety enclosure           Safety enclosure frame/canopy for use with hospital bed, any
   E0325          No Change       Urinal male jug-type           Urinal; male, jug-type, any material
   E0326          No Change       Urinal female jug-type         Urinal; female, jug-type, any material
   E0328          No Change       Ped hospital bed, manual       Hospital bed, pediatric, manual, 360 degree side enclosures,
   E0329          No Change       Ped hospital bed semi/elect    Hospital bed, pediatric, electric or semi-electric, 360 degre
   E0350          No Change       Control unit bowel system      Control unit for electronic bowel irrigation/evacuation syste
   E0352          No Change       Disposable pack w/bowel syst   Disposable pack (water reservoir bag, speculum, valving mecha
   E0370          No Change       Air elevator for heel          Air pressure elevator for heel
   E0371          No Change       Nonpower mattress overlay      Nonpowered advanced pressure reducing overlay for mattress, s
   E0372          No Change       Powered air mattress overlay   Powered air overlay for mattress, standard mattress length an
   E0373          No Change       Nonpowered pressure mattress   Nonpowered advanced pressure reducing mattress
   E0424          No Change       Stationary compressed gas 02   Stationary compressed gaseous oxygen system, rental; includes
   E0425          No Change       Gas system stationary compre   Stationary compressed gas system, purchase; includes regulato
   E0430          No Change       Oxygen system gas portable     Portable gaseous oxygen system, purchase; includes regulator,
   E0431          No Change       Portable gaseous 02            Portable gaseous oxygen system, rental; includes portable con
   E0433          No Change       Portable liquid oxygen sys     Portable liquid oxygen system, rental; home liquefier used to
   E0434          No Change       Portable liquid 02             Portable liquid oxygen system, rental; includes portable cont
   E0435          No Change       Oxygen system liquid portabl   Portable liquid oxygen system, purchase; includes portable co
   E0439          No Change       Stationary liquid 02           Stationary liquid oxygen system, rental; includes container,
   E0440          No Change       Oxygen system liquid station   Stationary liquid oxygen system, purchase; includes use of re
   E0441          No Change       Stationary o2 contents, gas    Stationary oxygen contents, gaseous, 1 month's supply = 1 uni
   E0442          No Change       Stationary o2 contents, liq    Stationary oxygen contents, liquid, 1 month's supply = 1 unit
   E0443          No Change       Portable 02 contents, gas      Portable oxygen contents, gaseous, 1 month's supply = 1 unit
   E0444          No Change       Portable 02 contents, liquid   Portable oxygen contents, liquid, 1 month's supply = 1 unit
   E0445          No Change       Oximeter non-invasive          Oximeter device for measuring blood oxygen levels non-invasiv
   E0446          No Change       Topical ox deliver sys, nos    Topical oxygen delivery system, not otherwise specified, incl
   E0450          No Change       Vol control vent invasiv int   Volume control ventilator, without pressure support mode, may
   E0455          No Change       Oxygen tent excl croup/ped t   Oxygen tent, excluding croup or pediatric tents
   E0457          No Change       Chest shell                    Chest shell (cuirass)
   E0459          No Change       Chest wrap                     Chest wrap
   E0460          No Change       Neg press vent portabl/statn   Negative pressure ventilator; portable or stationary
   E0461          No Change       Vol control vent noninv int    Volume control ventilator, without pressure support mode, may
   E0462          No Change       Rocking bed w/ or w/o side r   Rocking bed with or without side rails
   E0463          No Change       Press supp vent invasive int   Pressure support ventilator with volume control mode, may inc
   E0464          No Change       Press supp vent noninv int     Pressure support ventilator with volume control mode, may inc
   E0465          No Change       Home vent invasive interface   Home ventilator, any type, used with invasive interface, (e.g
   E0466          No Change       Home vent non-invasive inter   Home ventilator, any type, used with non-invasive interface,
   E0470          No Change       Rad w/o backup non-inv intfc   Respiratory assist device, bi-level pressure capability, with
   E0471          No Change       Rad w/backup non inv intrfc    Respiratory assist device, bi-level pressure capability, with
   E0472          No Change       Rad w backup invasive intrfc   Respiratory assist device, bi-level pressure capability, with
   E0480          No Change       Percussor elect/pneum home m   Percussor, electric or pneumatic, home model
   E0481          No Change       Intrpulmnry percuss vent sys   Intrapulmonary percussive ventilation system and related acce
   E0482          No Change       Cough stimulating device       Cough stimulating device, alternating positive and negative a
   E0484          No Change       Non-elec oscillatory pep dvc   Oscillatory positive expiratory pressure device, non-electric
   E0485          No Change       Oral device/appliance prefab   Oral device/appliance used to reduce upper airway collapsibil
   E0486          No Change       Oral device/appliance cusfab   Oral device/appliance used to reduce upper airway collapsibil
   E0487          No Change       Electronic spirometer          Spirometer, electronic, includes all accessories
   E0500          No Change       Ippb all types                 Ippb machine, all types, with built-in nebulization; manual o
   E0550          No Change       Humidif extens supple w ippb   Humidifier, durable for extensive supplemental humidification
   E0555          No Change       Humidifier for use w/ regula   Humidifier, durable, glass or autoclavable plastic bottle typ
   E0560          No Change       Humidifier supplemental w/ i   Humidifier, durable for supplemental humidification during ip
   E0561          No Change       Humidifier nonheated w pap     Humidifier, non-heated, used with positive airway pressure de
   E0562          No Change       Humidifier heated used w pap   Humidifier, heated, used with positive airway pressure device
   E0565          No Change       Compressor air power source    Compressor, air power source for equipment which is not self-
   E0570          No Change       Nebulizer with compression     Nebulizer, with compressor
   E0572          No Change       Aerosol compressor adjust pr   Aerosol compressor, adjustable pressure, light duty for inter
   E0574          No Change       Ultrasonic generator w svneb   Ultrasonic/electronic aerosol generator with small volume neb
   E0575          No Change       Nebulizer ultrasonic           Nebulizer, ultrasonic, large volume
   E0580          No Change       Nebulizer for use w/ regulat   Nebulizer, durable, glass or autoclavable plastic, bottle typ
   E0585          No Change       Nebulizer w/ compressor & he   Nebulizer, with compressor and heater
   E0600          No Change       Suction pump portab hom modl   Respiratory suction pump, home model, portable or stationary,
   E0601          No Change       Cont airway pressure device    Continuous positive airway pressure (cpap) device
   E0602          No Change       Manual breast pump             Breast pump, manual, any type
   E0603          No Change       Electric breast pump           Breast pump, electric (ac and/or dc), any type
   E0604          No Change       Hosp grade elec breast pump    Breast pump, hospital grade, electric (ac and / or dc), any t
   E0605          No Change       Vaporizer room type            Vaporizer, room type
   E0606          No Change       Drainage board postural        Postural drainage board
   E0607          No Change       Blood glucose monitor home     Home blood glucose monitor
   E0610          No Change       Pacemaker monitr audible/vis   Pacemaker monitor, self-contained, (checks battery depletion,
   E0615          No Change       Pacemaker monitr digital/vis   Pacemaker monitor, self contained, checks battery depletion a
   E0616          No Change       Cardiac event recorder         Implantable cardiac event recorder with memory, activator and
   E0617          No Change       Automatic ext defibrillator    External defibrillator with integrated electrocardiogram anal
   E0618          No Change       Apnea monitor                  Apnea monitor, without recording feature
   E0619          No Change       Apnea monitor w recorder       Apnea monitor, with recording feature
   E0620          No Change       Cap bld skin piercing laser    Skin piercing device for collection of capillary blood, laser
   E0621          No Change       Patient lift sling or seat     Sling or seat, patient lift, canvas or nylon
   E0625          No Change       Patient lift bathroom or toi   Patient lift, bathroom or toilet, not otherwise classified
   E0627          No Change       Seat lift mech, electric any   Seat lift mechanism, electric, any type
   E0628          No Change       Seat lift for pt furn-electr   Separate seat lift mechanism for use with patient owned furni
   E0629          No Change       Seat lift mech, non-electric   Seat lift mechanism, non-electric, any type
   E0630          No Change       Patient lift hydraulic         Patient lift, hydraulic or mechanical, includes any seat, sli
   E0635          No Change       Patient lift electric          Patient lift, electric with seat or sling
   E0636          No Change       Pt support & positioning sys   Multipositional patient support system, with integrated lift,
   E0637          No Change       Combination sit to stand sys   Combination sit to stand frame/table system, any size includi
   E0638          No Change       Standing frame sys             Standing frame/table system, one position (e.g., upright, sup
   E0639          No Change       Moveable patient lift system   Patient lift, moveable from room to room with disassembly and
   E0640          No Change       Fixed patient lift system      Patient lift, fixed system, includes all components/accessori
   E0641          No Change       Multi-position stnd fram sys   Standing frame/table system, multi-position (e.g., three-way
   E0642          No Change       Dynamic standing frame         Standing frame/table system, mobile (dynamic stander), any si
   E0650          No Change       Pneuma compresor non-segment   Pneumatic compressor, non-segmental home model
   E0651          No Change       Pneum compressor segmental     Pneumatic compressor, segmental home model without calibrated
   E0652          No Change       Pneum compres w/cal pressure   Pneumatic compressor, segmental home model with calibrated gr
   E0655          No Change       Pneumatic appliance half arm   Non-segmental pneumatic appliance for use with pneumatic comp
   E0656          No Change       Segmental pneumatic trunk      Segmental pneumatic appliance for use with pneumatic compress
   E0657          No Change       Segmental pneumatic chest      Segmental pneumatic appliance for use with pneumatic compress
   E0660          No Change       Pneumatic appliance full leg   Non-segmental pneumatic appliance for use with pneumatic comp
   E0665          No Change       Pneumatic appliance full arm   Non-segmental pneumatic appliance for use with pneumatic comp
   E0666          No Change       Pneumatic appliance half leg   Non-segmental pneumatic appliance for use with pneumatic comp
   E0667          No Change       Seg pneumatic appl full leg    Segmental pneumatic appliance for use with pneumatic compress
   E0668          No Change       Seg pneumatic appl full arm    Segmental pneumatic appliance for use with pneumatic compress
   E0669          No Change       Seg pneumatic appli half leg   Segmental pneumatic appliance for use with pneumatic compress
   E0670          No Change       Seg pneum int legs/trunk       Segmental pneumatic appliance for use with pneumatic compress
   E0671          No Change       Pressure pneum appl full leg   Segmental gradient pressure pneumatic appliance, full leg
   E0672          No Change       Pressure pneum appl full arm   Segmental gradient pressure pneumatic appliance, full arm
   E0673          No Change       Pressure pneum appl half leg   Segmental gradient pressure pneumatic appliance, half leg
   E0675          No Change       Pneumatic compression device   Pneumatic compression device, high pressure, rapid inflation/
   E0676          No Change       Inter limb compress dev nos    Intermittent limb compression device (includes all accessorie
   E0691          No Change       Uvl pnl 2 sq ft or less        Ultraviolet light therapy system, includes bulbs/lamps, timer
   E0692          No Change       Uvl sys panel 4 ft             Ultraviolet light therapy system panel, includes bulbs/lamps,
   E0693          No Change       Uvl sys panel 6 ft             Ultraviolet light therapy system panel, includes bulbs/lamps,
   E0694          No Change       Uvl md cabinet sys 6 ft        Ultraviolet multidirectional light therapy system in 6 foot c
   E0700          No Change       Safety equipment               Safety equipment, device or accessory, any type
   E0705          No Change       Transfer device                Transfer device, any type, each
   E0710          No Change       Restraints any type            Restraints, any type (body, chest, wrist or ankle)
   E0720          No Change       Tens two lead                  Transcutaneous electrical nerve stimulation (tens) device, tw
   E0730          No Change       Tens four lead                 Transcutaneous electrical nerve stimulation (tens) device, fo
   E0731          No Change       Conductive garment for tens/   Form fitting conductive garment for delivery of tens or nmes
   E0740          No Change       Non-implant pelv flr e-stim    Non-implanted pelvic floor electrical stimulator, complete sy
   E0744          No Change       Neuromuscular stim for scoli   Neuromuscular stimulator for scoliosis
   E0745          No Change       Neuromuscular stim for shock   Neuromuscular stimulator, electronic shock unit
   E0746          No Change       Electromyograph biofeedback    Electromyography (emg), biofeedback device
   E0747          No Change       Elec osteogen stim not spine   Osteogenesis stimulator, electrical, non-invasive, other than
   E0748          No Change       Elec osteogen stim spinal      Osteogenesis stimulator, electrical, non-invasive, spinal app
   E0749          No Change       Elec osteogen stim implanted   Osteogenesis stimulator, electrical, surgically implanted
   E0755          No Change       Electronic salivary reflex s   Electronic salivary reflex stimulator (intra-oral/non-invasiv
   E0760          No Change       Osteogen ultrasound stimltor   Osteogenesis stimulator, low intensity ultrasound, non-invasi
   E0761          No Change       Nontherm electromgntc device   Non-thermal pulsed high frequency radiowaves, high peak power
   E0762          No Change       Trans elec jt stim dev sys     Transcutaneous electrical joint stimulation device system, in
   E0764          No Change       Functional neuromuscularstim   Functional neuromuscular stimulation, transcutaneous stimulat
   E0765          No Change       Nerve stimulator for tx n&v    Fda approved nerve stimulator, with replaceable batteries, fo
   E0766          No Change       Elec stim cancer treatment     Electrical stimulation device used for cancer treatment, incl
   E0769          No Change       Electric wound treatment dev   Electrical stimulation or electromagnetic wound treatment dev
   E0770          No Change       Functional electric stim nos   Functional electrical stimulator, transcutaneous stimulation
   E0776          No Change       Iv pole                        Iv pole
   E0779          No Change       Amb infusion pump mechanical   Ambulatory infusion pump, mechanical, reusable, for infusion
   E0780          No Change       Mech amb infusion pump <8hrs   Ambulatory infusion pump, mechanical, reusable, for infusion
   E0781          No Change       External ambulatory infus pu   Ambulatory infusion pump, single or multiple channels, electr
   E0782          No Change       Non-programble infusion pump   Infusion pump, implantable, non-programmable (includes all co
   E0783          No Change       Programmable infusion pump     Infusion pump system, implantable, programmable (includes all
   E0784          No Change       Ext amb infusn pump insulin    External ambulatory infusion pump, insulin
   E0785          No Change       Replacement impl pump cathet   Implantable intraspinal (epidural/intrathecal) catheter used
   E0786          No Change       Implantable pump replacement   Implantable programmable infusion pump, replacement (excludes
   E0791          No Change       Parenteral infusion pump sta   Parenteral infusion pump, stationary, single or multi-channel
   E0830          No Change       Ambulatory traction device     Ambulatory traction device, all types, each
   E0840          No Change       Tract frame attach headboard   Traction frame, attached to headboard, cervical traction
   E0849          No Change       Cervical pneum trac equip      Traction equipment, cervical, free-standing stand/frame, pneu
   E0850          No Change       Traction stand free standing   Traction stand, free standing, cervical traction
   E0855          No Change       Cervical traction equipment    Cervical traction equipment not requiring additional stand or
   E0856          No Change       Cervic collar w air bladders   Cervical traction device, with inflatable air bladder(s)
   E0860          No Change       Tract equip cervical tract     Traction equipment, overdoor, cervical
   E0870          No Change       Tract frame attach footboard   Traction frame, attached to footboard, extremity traction, (e
   E0880          No Change       Trac stand free stand extrem   Traction stand, free standing, extremity traction, (e.g., buc
   E0890          No Change       Traction frame attach pelvic   Traction frame, attached to footboard, pelvic traction
   E0900          No Change       Trac stand free stand pelvic   Traction stand, free standing, pelvic traction, (e.g., buck's
   E0910          No Change       Trapeze bar attached to bed    Trapeze bars, a/k/a patient helper, attached to bed, with gra
   E0911          No Change       Hd trapeze bar attach to bed   Trapeze bar, heavy duty, for patient weight capacity greater
   E0912          No Change       Hd trapeze bar free standing   Trapeze bar, heavy duty, for patient weight capacity greater
   E0920          No Change       Fracture frame attached to b   Fracture frame, attached to bed, includes weights
   E0930          No Change       Fracture frame free standing   Fracture frame, free standing, includes weights
   E0935          No Change       Cont pas motion exercise dev   Continuous passive motion exercise device for use on knee onl
   E0936          No Change       Cpm device, other than knee    Continuous passive motion exercise device for use other than
   E0940          No Change       Trapeze bar free standing      Trapeze bar, free standing, complete with grab bar
   E0941          No Change       Gravity assisted traction de   Gravity assisted traction device, any type
   E0942          No Change       Cervical head harness/halter   Cervical head harness/halter
   E0944          No Change       Pelvic belt/harness/boot       Pelvic belt/harness/boot
   E0945          No Change       Belt/harness extremity         Extremity belt/harness
   E0946          No Change       Fracture frame dual w cross    Fracture, frame, dual with cross bars, attached to bed, (e.g.
   E0947          No Change       Fracture frame attachmnts pe   Fracture frame, attachments for complex pelvic traction
   E0948          No Change       Fracture frame attachmnts ce   Fracture frame, attachments for complex cervical traction
   E0950          No Change       Tray                           Wheelchair accessory, tray, each
   E0951          No Change       Loop heel                      Heel loop/holder, any type, with or without ankle strap, each
   E0952          No Change       Toe loop/holder, each          Toe loop/holder, any type, each
   E0953          No Change       W/c lateral thigh/knee sup     Wheelchair accessory, lateral thigh or knee support, any type
   E0954          No Change       Foot box, any type each foot   Wheelchair accessory, foot box, any type, includes attachment
   E0955          No Change       Cushioned headrest             Wheelchair accessory, headrest, cushioned, any type, includin
   E0956          No Change       W/c lateral trunk/hip suppor   Wheelchair accessory, lateral trunk or hip support, any type,
   E0957          No Change       W/c medial thigh support       Wheelchair accessory, medial thigh support, any type, includi
   E0958          No Change       Whlchr att- conv 1 arm drive   Manual wheelchair accessory, one-arm drive attachment, each
   E0959          No Change       Amputee adapter                Manual wheelchair accessory, adapter for amputee, each
   E0960          No Change       W/c shoulder harness/straps    Wheelchair accessory, shoulder harness/straps or chest strap,
   E0961          No Change       Wheelchair brake extension     Manual wheelchair accessory, wheel lock brake extension (hand
   E0966          No Change       Wheelchair head rest extensi   Manual wheelchair accessory, headrest extension, each
   E0967          No Change       Man wc rim/projection rep ea   Manual wheelchair accessory, hand rim with projections, any t
   E0968          No Change       Wheelchair commode seat        Commode seat, wheelchair
   E0969          No Change       Wheelchair narrowing device    Narrowing device, wheelchair
   E0970          No Change       Wheelchair no. 2 footplates    No. 2 footplates, except for elevating leg rest
   E0971          No Change       Wheelchair anti-tipping devi   Manual wheelchair accessory, anti-tipping device, each
   E0973          No Change       W/ch access det adj armrest    Wheelchair accessory, adjustable height, detachable armrest,
   E0974          No Change       W/ch access anti-rollback      Manual wheelchair accessory, anti-rollback device, each
   E0978          No Change       W/c acc,saf belt pelv strap    Wheelchair accessory, positioning belt/safety belt/pelvic str
   E0980          No Change       Wheelchair safety vest         Safety vest, wheelchair
   E0981          No Change       Seat upholstery, replacement   Wheelchair accessory, seat upholstery, replacement only, each
   E0982          No Change       Back upholstery, replacement   Wheelchair accessory, back upholstery, replacement only, each
   E0983          No Change       Add pwr joystick               Manual wheelchair accessory, power add-on to convert manual w
   E0984          No Change       Add pwr tiller                 Manual wheelchair accessory, power add-on to convert manual w
   E0985          No Change       W/c seat lift mechanism        Wheelchair accessory, seat lift mechanism
   E0986          No Change       Man w/c push-rim powr system   Manual wheelchair accessory, push-rim activated power assist
   E0988          No Change       Lever-activated wheel drive    Manual wheelchair accessory, lever-activated, wheel drive, pa
   E0990          No Change       Wheelchair elevating leg res   Wheelchair accessory, elevating leg rest, complete assembly,
   E0992          No Change       Wheelchair solid seat insert   Manual wheelchair accessory, solid seat insert
   E0994          No Change       Wheelchair arm rest            Arm rest, each
   E0995          No Change       Wc calf rest, pad replacemnt   Wheelchair accessory, calf rest/pad, replacement only, each
   E1002          No Change       Pwr seat tilt                  Wheelchair accessory, power seating system, tilt only
   E1003          No Change       Pwr seat recline               Wheelchair accessory, power seating system, recline only, wit
   E1004          No Change       Pwr seat recline mech          Wheelchair accessory, power seating system, recline only, wit
   E1005          No Change       Pwr seat recline pwr           Wheelchair accessory, power seatng system, recline only, with
   E1006          No Change       Pwr seat combo w/o shear       Wheelchair accessory, power seating system, combination tilt
   E1007          No Change       Pwr seat combo w/shear         Wheelchair accessory, power seating system, combination tilt
   E1008          No Change       Pwr seat combo pwr shear       Wheelchair accessory, power seating system, combination tilt
   E1009          No Change       Add mech leg elevation         Wheelchair accessory, addition to power seating system, mecha
   E1010          No Change       Add pwr leg elevation          Wheelchair accessory, addition to power seating system, power
   E1011          No Change       Ped wc modify width adjustm    Modification to pediatric size wheelchair, width adjustment p
   E1012          No Change       Ctr mount pwr elev leg rest    Wheelchair accessory, addition to power seating system, cente
   E1014          No Change       Reclining back add ped w/c     Reclining back, addition to pediatric size wheelchair
   E1015          No Change       Shock absorber for man w/c     Shock absorber for manual wheelchair, each
   E1016          No Change       Shock absorber for power w/c   Shock absorber for power wheelchair, each
   E1017          No Change       Hd shck absrbr for hd man wc   Heavy duty shock absorber for heavy duty or extra heavy duty
   E1018          No Change       Hd shck absrber for hd powwc   Heavy duty shock absorber for heavy duty or extra heavy duty
   E1020          No Change       Residual limb support system   Residual limb support system for wheelchair, any type
   E1028          No Change       W/c manual swingaway           Wheelchair accessory, manual swingaway, retractable or remova
   E1029          No Change       W/c vent tray fixed            Wheelchair accessory, ventilator tray, fixed
   E1030          No Change       W/c vent tray gimbaled         Wheelchair accessory, ventilator tray, gimbaled
   E1031          No Change       Rollabout chair with casters   Rollabout chair, any and all types with casters 5" or greater
   E1035          No Change       Patient transfer system <300   Multi-positional patient transfer system, with integrated sea
   E1036          No Change       Patient transfer system >300   Multi-positional patient transfer system, extra-wide, with in
   E1037          No Change       Transport chair, ped size      Transport chair, pediatric size
   E1038          No Change       Transport chair pt wt<=300lb   Transport chair, adult size, patient weight capacity up to an
   E1039          No Change       Transport chair pt wt >300lb   Transport chair, adult size, heavy duty, patient weight capac
   E1050          No Change       Whelchr fxd full length arms   Fully-reclining wheelchair, fixed full length arms, swing awa
   E1060          No Change       Wheelchair detachable arms     Fully-reclining wheelchair, detachable arms, desk or full len
   E1070          No Change       Wheelchair detachable foot r   Fully-reclining wheelchair, detachable arms (desk or full len
   E1083          No Change       Hemi-wheelchair fixed arms     Hemi-wheelchair, fixed full length arms, swing away detachabl
   E1084          No Change       Hemi-wheelchair detachable a   Hemi-wheelchair, detachable arms desk or full length arms, sw
   E1085          No Change       Hemi-wheelchair fixed arms     Hemi-wheelchair, fixed full length arms, swing away detachabl
   E1086          No Change       Hemi-wheelchair detachable a   Hemi-wheelchair detachable arms desk or full length, swing aw
   E1087          No Change       Wheelchair lightwt fixed arm   High strength lightweight wheelchair, fixed full length arms,
   E1088          No Change       Wheelchair lightweight det a   High strength lightweight wheelchair, detachable arms desk or
   E1089          No Change       Wheelchair lightwt fixed arm   High strength lightweight wheelchair, fixed length arms, swin
   E1090          No Change       Wheelchair lightweight det a   High strength lightweight wheelchair, detachable arms desk or
   E1092          No Change       Wheelchair wide w/ leg rests   Wide heavy duty wheel chair, detachable arms (desk or full le
   E1093          No Change       Wheelchair wide w/ foot rest   Wide heavy duty wheelchair, detachable arms desk or full leng
   E1100          No Change       Whchr s-recl fxd arm leg res   Semi-reclining wheelchair, fixed full length arms, swing away
   E1110          No Change       Wheelchair semi-recl detach    Semi-reclining wheelchair, detachable arms (desk or full leng
   E1130          No Change       Whlchr stand fxd arm ft rest   Standard wheelchair, fixed full length arms, fixed or swing a
   E1140          No Change       Wheelchair standard detach a   Wheelchair, detachable arms, desk or full length, swing away
   E1150          No Change       Wheelchair standard w/ leg r   Wheelchair, detachable arms, desk or full length swing away d
   E1160          No Change       Wheelchair fixed arms          Wheelchair, fixed full length arms, swing away detachable ele
   E1161          No Change       Manual adult wc w tiltinspac   Manual adult size wheelchair, includes tilt in space
   E1170          No Change       Whlchr ampu fxd arm leg rest   Amputee wheelchair, fixed full length arms, swing away detach
   E1171          No Change       Wheelchair amputee w/o leg r   Amputee wheelchair, fixed full length arms, without footrests
   E1172          No Change       Wheelchair amputee detach ar   Amputee wheelchair, detachable arms (desk or full length) wit
   E1180          No Change       Wheelchair amputee w/ foot r   Amputee wheelchair, detachable arms (desk or full length) swi
   E1190          No Change       Wheelchair amputee w/ leg re   Amputee wheelchair, detachable arms (desk or full length) swi
   E1195          No Change       Wheelchair amputee heavy dut   Heavy duty wheelchair, fixed full length arms, swing away det
   E1200          No Change       Wheelchair amputee fixed arm   Amputee wheelchair, fixed full length arms, swing away detach
   E1220          No Change       Whlchr special size/constrc    Wheelchair; specially sized or constructed, (indicate brand n
   E1221          No Change       Wheelchair spec size w foot    Wheelchair with fixed arm, footrests
   E1222          No Change       Wheelchair spec size w/ leg    Wheelchair with fixed arm, elevating legrests
   E1223          No Change       Wheelchair spec size w foot    Wheelchair with detachable arms, footrests
   E1224          No Change       Wheelchair spec size w/ leg    Wheelchair with detachable arms, elevating legrests
   E1225          No Change       Manual semi-reclining back     Wheelchair accessory, manual semi-reclining back, (recline gr
   E1226          No Change       Manual fully reclining back    Wheelchair accessory, manual fully reclining back, (recline g
   E1227          No Change       Wheelchair spec sz spec ht a   Special height arms for wheelchair
   E1228          No Change       Wheelchair spec sz spec ht b   Special back height for wheelchair
   E1229          No Change       Pediatric wheelchair nos       Wheelchair, pediatric size, not otherwise specified
   E1230          No Change       Power operated vehicle         Power operated vehicle (three or four wheel nonhighway) speci
   E1231          No Change       Rigid ped w/c tilt-in-space    Wheelchair, pediatric size, tilt-in-space, rigid, adjustable,
   E1232          No Change       Folding ped wc tilt-in-space   Wheelchair, pediatric size, tilt-in-space, folding, adjustabl
   E1233          No Change       Rig ped wc tltnspc w/o seat    Wheelchair, pediatric size, tilt-in-space, rigid, adjustable,
   E1234          No Change       Fld ped wc tltnspc w/o seat    Wheelchair, pediatric size, tilt-in-space, folding, adjustabl
   E1235          No Change       Rigid ped wc adjustable        Wheelchair, pediatric size, rigid, adjustable, with seating s
   E1236          No Change       Folding ped wc adjustable      Wheelchair, pediatric size, folding, adjustable, with seating
   E1237          No Change       Rgd ped wc adjstabl w/o seat   Wheelchair, pediatric size, rigid, adjustable, without seatin
   E1238          No Change       Fld ped wc adjstabl w/o seat   Wheelchair, pediatric size, folding, adjustable, without seat
   E1239          No Change       Ped power wheelchair nos       Power wheelchair, pediatric size, not otherwise specified
   E1240          No Change       Whchr litwt det arm leg rest   Lightweight wheelchair, detachable arms, (desk or full length
   E1250          No Change       Wheelchair lightwt fixed arm   Lightweight wheelchair, fixed full length arms, swing away de
   E1260          No Change       Wheelchair lightwt foot rest   Lightweight wheelchair, detachable arms (desk or full length)
   E1270          No Change       Wheelchair lightweight leg r   Lightweight wheelchair, fixed full length arms, swing away de
   E1280          No Change       Whchr h-duty det arm leg res   Heavy duty wheelchair, detachable arms (desk or full length)
   E1285          No Change       Wheelchair heavy duty fixed    Heavy duty wheelchair, fixed full length arms, swing away det
   E1290          No Change       Wheelchair hvy duty detach a   Heavy duty wheelchair, detachable arms (desk or full length)
   E1295          No Change       Wheelchair heavy duty fixed    Heavy duty wheelchair, fixed full length arms, elevating legr
   E1296          No Change       Wheelchair special seat heig   Special wheelchair seat height from floor
   E1297          No Change       Wheelchair special seat dept   Special wheelchair seat depth, by upholstery
   E1298          No Change       Wheelchair spec seat depth/w   Special wheelchair seat depth and/or width, by construction
   E1300          No Change       Whirlpool portable             Whirlpool, portable (overtub type)
   E1310          No Change       Whirlpool non-portable         Whirlpool, non-portable (built-in type)
   E1352          No Change       O2 flow reg pos inspir press   Oxygen accessory, flow regulator capable of positive inspirat
   E1353          No Change       Oxygen supplies regulator      Regulator
   E1354          No Change       Wheeled cart, port cyl/conc    Oxygen accessory, wheeled cart for portable cylinder or porta
   E1355          No Change       Oxygen supplies stand/rack     Stand/rack
   E1356          No Change       Batt pack/cart, port conc      Oxygen accessory, battery pack/cartridge for portable concent
   E1357          No Change       Battery charger, port conc     Oxygen accessory, battery charger for portable concentrator,
   E1358          No Change       Dc power adapter, port conc    Oxygen accessory, dc power adapter for portable concentrator,
   E1372          No Change       Oxy suppl heater for nebuliz   Immersion external heater for nebulizer
   E1390          No Change       Oxygen concentrator            Oxygen concentrator, single delivery port, capable of deliver
   E1391          No Change       Oxygen concentrator, dual      Oxygen concentrator, dual delivery port, capable of deliverin
   E1392          No Change       Portable oxygen concentrator   Portable oxygen concentrator, rental
   E1399          No Change       Durable medical equipment mi   Durable medical equipment, miscellaneous
   E1405          No Change       O2/water vapor enrich w/heat   Oxygen and water vapor enriching system with heated delivery
   E1406          No Change       O2/water vapor enrich w/o he   Oxygen and water vapor enriching system without heated delive
   E1500          No Change       Centrifuge                     Centrifuge, for dialysis
   E1510          No Change       Kidney dialysate delivry sys   Kidney, dialysate delivery syst kidney machine, pump recircul
   E1520          No Change       Heparin infusion pump          Heparin infusion pump for hemodialysis
   E1530          No Change       Replacement air bubble detec   Air bubble detector for hemodialysis, each, replacement
   E1540          No Change       Replacement pressure alarm     Pressure alarm for hemodialysis, each, replacement
   E1550          No Change       Bath conductivity meter        Bath conductivity meter for hemodialysis, each
   E1560          No Change       Replace blood leak detector    Blood leak detector for hemodialysis, each, replacement
   E1570          No Change       Adjustable chair for esrd pt   Adjustable chair, for esrd patients
   E1575          No Change       Transducer protect/fld bar     Transducer protectors/fluid barriers, for hemodialysis, any s
   E1580          No Change       Unipuncture control system     Unipuncture control system for hemodialysis
   E1590          No Change       Hemodialysis machine           Hemodialysis machine
   E1592          No Change       Auto interm peritoneal dialy   Automatic intermittent peritoneal dialysis system
   E1594          No Change       Cycler dialysis machine        Cycler dialysis machine for peritoneal dialysis
   E1600          No Change       Deli/install chrg hemo equip   Delivery and/or installation charges for hemodialysis equipme
   E1610          No Change       Reverse osmosis h2o puri sys   Reverse osmosis water purification system, for hemodialysis
   E1615          No Change       Deionizer h2o puri system      Deionizer water purification system, for hemodialysis
   E1620          No Change       Replacement blood pump         Blood pump for hemodialysis, replacement
   E1625          No Change       Water softening system         Water softening system, for hemodialysis
   E1630          No Change       Reciprocating peritoneal dia   Reciprocating peritoneal dialysis system
   E1632          No Change       Wearable artificial kidney     Wearable artificial kidney, each
   E1634          No Change       Peritoneal dialysis clamp      Peritoneal dialysis clamps, each
   E1635          No Change       Compact travel hemodialyzer    Compact (portable) travel hemodialyzer system
   E1636          No Change       Sorbent cartridges per 10      Sorbent cartridges, for hemodialysis, per 10
   E1637          No Change       Hemostats for dialysis, each   Hemostats, each
   E1639          No Change       Scale, each                    Scale, each
   E1699          No Change       Dialysis equipment noc         Dialysis equipment, not otherwise specified
   E1700          No Change       Jaw motion rehab system        Jaw motion rehabilitation system
   E1701          No Change       Repl cushions for jaw motion   Replacement cushions for jaw motion rehabilitation system, pk
   E1702          No Change       Repl measr scales jaw motion   Replacement measuring scales for jaw motion rehabilitation sy
   E1800          No Change       Adjust elbow ext/flex device   Dynamic adjustable elbow extension/flexion device, includes s
   E1801          No Change       Sps elbow device               Static progressive stretch elbow device, extension and/or fle
   E1802          No Change       Adjst forearm pro/sup device   Dynamic adjustable forearm pronation/supination device, inclu
   E1805          No Change       Adjust wrist ext/flex device   Dynamic adjustable wrist extension / flexion device, includes
   E1806          No Change       Sps wrist device               Static progressive stretch wrist device, flexion and/or exten
   E1810          No Change       Adjust knee ext/flex device    Dynamic adjustable knee extension / flexion device, includes
   E1811          No Change       Sps knee device                Static progressive stretch knee device, extension and/or flex
   E1812          No Change       Knee ext/flex w act res ctrl   Dynamic knee, extension/flexion device with active resistance
   E1815          No Change       Adjust ankle ext/flex device   Dynamic adjustable ankle extension/flexion device, includes s
   E1816          No Change       Sps ankle device               Static progressive stretch ankle device, flexion and/or exten
   E1818          No Change       Sps forearm device             Static progressive stretch forearm pronation / supination dev
   E1820          No Change       Soft interface material        Replacement soft interface material, dynamic adjustable exten
   E1821          No Change       Replacement interface spsd     Replacement soft interface material/cuffs for bi-directional
   E1825          No Change       Adjust finger ext/flex devc    Dynamic adjustable finger extension/flexion device, includes
   E1830          No Change       Adjust toe ext/flex device     Dynamic adjustable toe extension/flexion device, includes sof
   E1831          No Change       Static str toe dev ext/flex    Static progressive stretch toe device, extension and/or flexi
   E1840          No Change       Adj shoulder ext/flex device   Dynamic adjustable shoulder flexion / abduction / rotation de
   E1841          No Change       Static str shldr dev rom adj   Static progressive stretch shoulder device, with or without r
   E1902          No Change       Aac non-electronic board       Communication board, non-electronic augmentative or alternati
   E2000          No Change       Gastric suction pump hme mdl   Gastric suction pump, home model, portable or stationary, ele
   E2100          No Change       Bld glucose monitor w voice    Blood glucose monitor with integrated voice synthesizer
   E2101          No Change       Bld glucose monitor w lance    Blood glucose monitor with integrated lancing/blood sample
   E2120          No Change       Pulse gen sys tx endolymp fl   Pulse generator system for tympanic treatment of inner ear en
   E2201          No Change       Man w/ch acc seat w>=20"<24"   Manual wheelchair accessory, nonstandard seat frame, width gr
   E2202          No Change       Seat width 24-27 in            Manual wheelchair accessory, nonstandard seat frame width, 24
   E2203          No Change       Frame depth less than 22 in    Manual wheelchair accessory, nonstandard seat frame depth, 20
   E2204          No Change       Frame depth 22 to 25 in        Manual wheelchair accessory, nonstandard seat frame depth, 22
   E2205          No Change       Manual wc accessory, handrim   Manual wheelchair accessory, handrim without projections (inc
   E2206          No Change       Man wc whl lock comp repl ea   Manual wheelchair accessory, wheel lock assembly, complete, r
   E2207          No Change       Crutch and cane holder         Wheelchair accessory, crutch and cane holder, each
   E2208          No Change       Cylinder tank carrier          Wheelchair accessory, cylinder tank carrier, each
   E2209          No Change       Arm trough each                Accessory, arm trough, with or without hand support, each
   E2210          No Change       Wheelchair bearings            Wheelchair accessory, bearings, any type, replacement only, e
   E2211          No Change       Pneumatic propulsion tire      Manual wheelchair accessory, pneumatic propulsion tire, any s
   E2212          No Change       Pneumatic prop tire tube       Manual wheelchair accessory, tube for pneumatic propulsion ti
   E2213          No Change       Pneumatic prop tire insert     Manual wheelchair accessory, insert for pneumatic propulsion
   E2214          No Change       Pneumatic caster tire each     Manual wheelchair accessory, pneumatic caster tire, any size,
   E2215          No Change       Pneumatic caster tire tube     Manual wheelchair accessory, tube for pneumatic caster tire,
   E2216          No Change       Foam filled propulsion tire    Manual wheelchair accessory, foam filled propulsion tire, any
   E2217          No Change       Foam filled caster tire each   Manual wheelchair accessory, foam filled caster tire, any siz
   E2218          No Change       Foam propulsion tire each      Manual wheelchair accessory, foam propulsion tire, any size,
   E2219          No Change       Foam caster tire any size ea   Manual wheelchair accessory, foam caster tire, any size, each
   E2220          No Change       Solid propuls tire, repl, ea   Manual wheelchair accessory, solid (rubber/plastic) propulsio
   E2221          No Change       Solid caster tire repl, each   Manual wheelchair accessory, solid (rubber/plastic) caster ti
   E2222          No Change       Solid caster integ whl, repl   Manual wheelchair accessory, solid (rubber/plastic) caster ti
   E2224          No Change       Propulsion whl excl tire rep   Manual wheelchair accessory, propulsion wheel excludes tire,
   E2225          No Change       Caster wheel excludes tire     Manual wheelchair accessory, caster wheel excludes tire, any
   E2226          No Change       Caster fork replacement only   Manual wheelchair accessory, caster fork, any size, replaceme
   E2227          No Change       Gear reduction drive wheel     Manual wheelchair accessory, gear reduction drive wheel, each
   E2228          No Change       Mwc acc, wheelchair brake      Manual wheelchair accessory, wheel braking system and lock, c
   E2230          No Change       Manual standing system         Manual wheelchair accessory, manual standing system
   E2231          No Change       Solid seat support base        Manual wheelchair accessory, solid seat support base (replace
   E2291          No Change       Planar back for ped size wc    Back, planar, for pediatric size wheelchair including fixed a
   E2292          No Change       Planar seat for ped size wc    Seat, planar, for pediatric size wheelchair including fixed a
   E2293          No Change       Contour back for ped size wc   Back, contoured, for pediatric size wheelchair including fixe
   E2294          No Change       Contour seat for ped size wc   Seat, contoured, for pediatric size wheelchair including fixe
   E2295          No Change       Ped dynamic seating frame      Manual wheelchair accessory, for pediatric size wheelchair, d
   E2300          No Change       Pwr seat elevation sys         Wheelchair accessory, power seat elevation system, any type
   E2301          No Change       Pwr standing                   Wheelchair accessory, power standing system, any type
   E2310          No Change       Electro connect btw control    Power wheelchair accessory, electronic connection between whe
   E2311          No Change       Electro connect btw 2 sys      Power wheelchair accessory, electronic connection between whe
   E2312          No Change       Mini-prop remote joystick      Power wheelchair accessory, hand or chin control interface, m
   E2313          No Change       Pwc harness, expand control    Power wheelchair accessory, harness for upgrade to expandable
   E2321          No Change       Hand interface joystick        Power wheelchair accessory, hand control interface, remote jo
   E2322          No Change       Mult mech switches             Power wheelchair accessory, hand control interface, multiple
   E2323          No Change       Special joystick handle        Power wheelchair accessory, specialty joystick handle for han
   E2324          No Change       Chin cup interface             Power wheelchair accessory, chin cup for chin control interfa
   E2325          No Change       Sip and puff interface         Power wheelchair accessory, sip and puff interface, nonpropor
   E2326          No Change       Breath tube kit                Power wheelchair accessory, breath tube kit for sip and puff
   E2327          No Change       Head control interface mech    Power wheelchair accessory, head control interface, mechanica
   E2328          No Change       Head/extremity control inter   Power wheelchair accessory, head control or extremity control
   E2329          No Change       Head control nonproportional   Power wheelchair accessory, head control interface, contact s
   E2330          No Change       Head control proximity switc   Power wheelchair accessory, head control interface, proximity
   E2331          No Change       Attendant control              Power wheelchair accessory, attendant control, proportional,
   E2340          No Change       W/c wdth 20-23 in seat frame   Power wheelchair accessory, nonstandard seat frame width, 20-
   E2341          No Change       W/c wdth 24-27 in seat frame   Power wheelchair accessory, nonstandard seat frame width, 24-
   E2342          No Change       W/c dpth 20-21 in seat frame   Power wheelchair accessory, nonstandard seat frame depth, 20
   E2343          No Change       W/c dpth 22-25 in seat frame   Power wheelchair accessory, nonstandard seat frame depth, 22-
   E2358          No Change       Gr 34 nonsealed leadacid       Power wheelchair accessory, group 34 non-sealed lead acid bat
   E2359          No Change       Gr34 sealed leadacid battery   Power wheelchair accessory, group 34 sealed lead acid battery
   E2360          No Change       22nf nonsealed leadacid        Power wheelchair accessory, 22nf non-sealed lead acid battery
   E2361          No Change       22nf sealed leadacid battery   Power wheelchair accessory, 22nf sealed lead acid battery, ea
   E2362          No Change       Gr24 nonsealed leadacid        Power wheelchair accessory, group 24 non-sealed lead acid bat
   E2363          No Change       Gr24 sealed leadacid battery   Power wheelchair accessory, group 24 sealed lead acid battery
   E2364          No Change       U1nonsealed leadacid battery   Power wheelchair accessory, u-1 non-sealed lead acid battery,
   E2365          No Change       U1 sealed leadacid battery     Power wheelchair accessory, u-1 sealed lead acid battery, eac
   E2366          No Change       Battery charger, single mode   Power wheelchair accessory, battery charger, single mode, for
   E2367          No Change       Battery charger, dual mode     Power wheelchair accessory, battery charger, dual mode, for u
   E2368          No Change       Pwr wc drivewheel motor repl   Power wheelchair component, drive wheel motor, replacement on
   E2369          No Change       Pwr wc drivewheel gear repl    Power wheelchair component, drive wheel gear box, replacement
   E2370          No Change       Pwr wc dr wh motor/gear comb   Power wheelchair component, integrated drive wheel motor and
   E2371          No Change       Gr27 sealed leadacid battery   Power wheelchair accessory, group 27 sealed lead acid battery
   E2372          No Change       Gr27 non-sealed leadacid       Power wheelchair accessory, group 27 non-sealed lead acid bat
   E2373          No Change       Hand/chin ctrl spec joystick   Power wheelchair accessory, hand or chin control interface, c
   E2374          No Change       Hand/chin ctrl std joystick    Power wheelchair accessory, hand or chin control interface, s
   E2375          No Change       Non-expandable controller      Power wheelchair accessory, non-expandable controller, includ
   E2376          No Change       Expandable controller, repl    Power wheelchair accessory, expandable controller, including
   E2377          No Change       Expandable controller, initl   Power wheelchair accessory, expandable controller, including
   E2378          No Change       Pw actuator replacement        Power wheelchair component, actuator, replacement only
   E2381          No Change       Pneum drive wheel tire         Power wheelchair accessory, pneumatic drive wheel tire, any s
   E2382          No Change       Tube, pneum wheel drive tire   Power wheelchair accessory, tube for pneumatic drive wheel ti
   E2383          No Change       Insert, pneum wheel drive      Power wheelchair accessory, insert for pneumatic drive wheel
   E2384          No Change       Pneumatic caster tire          Power wheelchair accessory, pneumatic caster tire, any size,
   E2385          No Change       Tube, pneumatic caster tire    Power wheelchair accessory, tube for pneumatic caster tire, a
   E2386          No Change       Foam filled drive wheel tire   Power wheelchair accessory, foam filled drive wheel tire, any
   E2387          No Change       Foam filled caster tire        Power wheelchair accessory, foam filled caster tire, any size
   E2388          No Change       Foam drive wheel tire          Power wheelchair accessory, foam drive wheel tire, any size,
   E2389          No Change       Foam caster tire               Power wheelchair accessory, foam caster tire, any size, repla
   E2390          No Change       Solid drive wheel tire         Power wheelchair accessory, solid (rubber/plastic) drive whee
   E2391          No Change       Solid caster tire              Power wheelchair accessory, solid (rubber/plastic) caster tir
   E2392          No Change       Solid caster tire, integrate   Power wheelchair accessory, solid (rubber/plastic) caster tir
   E2394          No Change       Drive wheel excludes tire      Power wheelchair accessory, drive wheel excludes tire, any si
   E2395          No Change       Caster wheel excludes tire     Power wheelchair accessory, caster wheel excludes tire, any s
   E2396          No Change       Caster fork                    Power wheelchair accessory, caster fork, any size, replacemen
   E2397          No Change       Pwc acc, lith-based battery    Power wheelchair accessory, lithium-based battery, each
   E2402          No Change       Neg press wound therapy pump   Negative pressure wound therapy electrical pump, stationary o
   E2511          No Change       Sgd sftwre prgrm for pc/pda    Speech generating software program, for personal computer or
   E2512          No Change       Sgd accessory, mounting sys    Accessory for speech generating device, mounting system
   E2599          No Change       Sgd accessory noc              Accessory for speech generating device, not otherwise classif
   E2601          No Change       Gen w/c cushion wdth < 22 in   General use wheelchair seat cushion, width less than 22 inche
   E2602          No Change       Gen w/c cushion wdth >=22 in   General use wheelchair seat cushion, width 22 inches or great
   E2603          No Change       Skin protect wc cus wd <22in   Skin protection wheelchair seat cushion, width less than 22 i
   E2604          No Change       Skin protect wc cus wd>=22in   Skin protection wheelchair seat cushion, width 22 inches or g
   E2605          No Change       Position wc cush wdth <22 in   Positioning wheelchair seat cushion, width less than 22 inche
   E2606          No Change       Position wc cush wdth>=22 in   Positioning wheelchair seat cushion, width 22 inches or great
   E2607          No Change       Skin pro/pos wc cus wd <22in   Skin protection and positioning wheelchair seat cushion, widt
   E2608          No Change       Skin pro/pos wc cus wd>=22in   Skin protection and positioning wheelchair seat cushion, widt
   E2609          No Change       Custom fabricate w/c cushion   Custom fabricated wheelchair seat cushion, any size
   E2610          No Change       Powered w/c cushion            Wheelchair seat cushion, powered
   E2611          No Change       Gen use back cush wdth <22in   General use wheelchair back cushion, width less than 22 inche
   E2612          No Change       Gen use back cush wdth>=22in   General use wheelchair back cushion, width 22 inches or great
   E2613          No Change       Position back cush wd <22in    Positioning wheelchair back cushion, posterior, width less th
   E2614          No Change       Position back cush wd>=22in    Positioning wheelchair back cushion, posterior, width 22 inch
   E2615          No Change       Pos back post/lat wdth <22in   Positioning wheelchair back cushion, posterior-lateral, width
   E2616          No Change       Pos back post/lat wdth>=22in   Positioning wheelchair back cushion, posterior-lateral, width
   E2617          No Change       Custom fab w/c back cushion    Custom fabricated wheelchair back cushion, any size, includin
   E2619          No Change       Replace cover w/c seat cush    Replacement cover for wheelchair seat cushion or back cushion
   E2620          No Change       Wc planar back cush wd <22in   Positioning wheelchair back cushion, planar back with lateral
   E2621          No Change       Wc planar back cush wd>=22in   Positioning wheelchair back cushion, planar back with lateral
   E2622          No Change       Adj skin pro w/c cus wd<22in   Skin protection wheelchair seat cushion, adjustable, width le
   E2623          No Change       Adj skin pro wc cus wd>=22in   Skin protection wheelchair seat cushion, adjustable, width 22
   E2624          No Change       Adj skin pro/pos cus<22in      Skin protection and positioning wheelchair seat cushion, adju
   E2625          No Change       Adj skin pro/pos wc cus>=22    Skin protection and positioning wheelchair seat cushion, adju
   E2626          No Change       Seo mobile arm sup att to wc   Wheelchair accessory, shoulder elbow, mobile arm support atta
   E2627          No Change       Arm supp att to wc rancho ty   Wheelchair accessory, shoulder elbow, mobile arm support atta
   E2628          No Change       Mobile arm supports reclinin   Wheelchair accessory, shoulder elbow, mobile arm support atta
   E2629          No Change       Friction dampening arm supp    Wheelchair accessory, shoulder elbow, mobile arm support atta
   E2630          No Change       Monosuspension arm/hand supp   Wheelchair accessory, shoulder elbow, mobile arm support, mon
   E2631          No Change       Elevat proximal arm support    Wheelchair accessory, addition to mobile arm support, elevati
   E2632          No Change       Offset/lat rocker arm w/ela    Wheelchair accessory, addition to mobile arm support, offset
   E2633          No Change       Mobile arm support supinator   Wheelchair accessory, addition to mobile arm support, supinat
   E8000          No Change       Posterior gait trainer         Gait trainer, pediatric size, posterior support, includes all
   E8001          No Change       Upright gait trainer           Gait trainer, pediatric size, upright support, includes all a
   E8002          No Change       Anterior gait trainer          Gait trainer, pediatric size, anterior support, includes all
   G0008          No Change       Admin influenza virus vac      Administration of influenza virus vaccine
   G0009          No Change       Admin pneumococcal vaccine     Administration of pneumococcal vaccine
   G0010          No Change       Admin hepatitis b vaccine      Administration of hepatitis b vaccine
   G0027          No Change       Semen analysis                 Semen analysis; presence and/or motility of sperm excluding h
   G0101          No Change       Ca screen;pelvic/breast exam   Cervical or vaginal cancer screening; pelvic and clinical bre
   G0102          No Change       Prostate ca screening; dre     Prostate cancer screening; digital rectal examination
   G0103          No Change       Psa screening                  Prostate cancer screening; prostate specific antigen test (ps
   G0104          No Change       Ca screen;flexi sigmoidscope   Colorectal cancer screening; flexible sigmoidoscopy
   G0105          No Change       Colorectal scrn; hi risk ind   Colorectal cancer screening; colonoscopy on individual at hig
   G0106          No Change       Colon ca screen;barium enema   Colorectal cancer screening; alternative to g0104, screening
   G0108          No Change       Diab manage trn  per indiv     Diabetes outpatient self-management training services, indivi
   G0109          No Change       Diab manage trn ind/group      Diabetes outpatient self-management training services, group
   G0117          No Change       Glaucoma scrn hgh risk direc   Glaucoma screening for high risk patients furnished by an opt
   G0118          No Change       Glaucoma scrn hgh risk direc   Glaucoma screening for high risk patient furnished under the
   G0120          No Change       Colon ca scrn; barium enema    Colorectal cancer screening; alternative to g0105, screening
   G0121          No Change       Colon ca scrn not hi rsk ind   Colorectal cancer screening; colonoscopy on individual not me
   G0122          No Change       Colon ca scrn; barium enema    Colorectal cancer screening; barium enema
   G0123          No Change       Screen cerv/vag thin layer     Screening cytopathology, cervical or vaginal (any reporting s
   G0124          No Change       Screen c/v thin layer by md    Screening cytopathology, cervical or vaginal (any reporting s
   G0127          No Change       Trim nail(s)                   Trimming of dystrophic nails, any number
   G0128          No Change       Corf skilled nursing service   Direct (face-to-face with patient) skilled nursing services o
   G0129          No Change       Partial hosp prog service      Occupational therapy services requiring the skills of a quali
   G0130          No Change       Single energy x-ray study      Single energy x-ray absorptiometry (sexa) bone density study,
   G0141          No Change       Scr c/v cyto,autosys and md    Screening cytopathology smears, cervical or vaginal, performe
   G0143          No Change       Scr c/v cyto,thinlayer,rescr   Screening cytopathology, cervical or vaginal (any reporting s
   G0144          No Change       Scr c/v cyto,thinlayer,rescr   Screening cytopathology, cervical or vaginal (any reporting s
   G0145          No Change       Scr c/v cyto,thinlayer,rescr   Screening cytopathology, cervical or vaginal (any reporting s
   G0147          No Change       Scr c/v cyto, automated sys    Screening cytopathology smears, cervical or vaginal, performe
   G0148          No Change       Scr c/v cyto, autosys, rescr   Screening cytopathology smears, cervical or vaginal, performe
   G0151          No Change       Hhcp-serv of pt,ea 15 min      Services performed by a qualified physical therapist in the h
   G0152          No Change       Hhcp-serv of ot,ea 15 min      Services performed by a qualified occupational therapist in t
   G0153          No Change       Hhcp-svs of s/l path,ea 15mn   Services performed by a qualified speech-language pathologist
   G0154          No Change       Hhcp-svs of rn,ea 15 min       Direct skilled nursing services of a licensed nurse (lpn or r
   G0155          No Change       Hhcp-svs of csw,ea 15 min      Services of clinical social worker in home health or hospice
   G0156          No Change       Hhcp-svs of aide,ea 15 min     Services of home health/hospice aide in home health or hospic
   G0157          No Change       Hhc pt assistant ea 15         Services performed by a qualified physical therapist assistan
   G0158          No Change       Hhc ot assistant ea 15         Services performed by a qualified occupational therapist assi
   G0159          No Change       Hhc pt maint ea 15 min         Services performed by a qualified physical therapist, in the
   G0160          No Change       Hhc occup therapy ea 15        Services performed by a qualified occupational therapist, in
   G0161          No Change       Hhc slp ea 15 min              Services performed by a qualified speech-language pathologist
   G0162          No Change       Hhc rn e&m plan svs, 15 min    Skilled services by a registered nurse (rn) for management an
   G0163          No Change       Hhc lpn/rn obs/asses ea 15     Skilled services of a licensed nurse (lpn or rn) for the obse
   G0164          No Change       Hhc lis nurse train ea 15      Skilled services of a licensed nurse (lpn or rn), in the trai
   G0166          No Change       Extrnl counterpulse, per tx    External counterpulsation, per treatment session
   G0168          No Change       Wound closure by adhesive      Wound closure utilizing tissue adhesive(s) only
   G0173          No Change       Linear acc stereo radsur com   Linear accelerator based stereotactic radiosurgery, complete
   G0175          No Change       Opps service,sched team conf   Scheduled interdisciplinary team conference (minimum of three
   G0176          No Change       Opps/php;activity therapy      Activity therapy, such as music, dance, art or play therapies
   G0177          No Change       Opps/php; train & educ serv    Training and educational services related to the care and tre
   G0179          No Change       Md recertification hha pt      Physician re-certification for medicare-covered home health s
   G0180          No Change       Md certification hha patient   Physician certification for medicare-covered home health serv
   G0181          No Change       Home health care supervision   Physician supervision of a patient receiving medicare-covered
   G0182          No Change       Hospice care supervision       Physician supervision of a patient under a medicare-approved
   G0186          No Change       Dstry eye lesn,fdr vssl tech   Destruction of localized lesion of choroid (for example, chor
   G0202          No Change       Scr mammo bi incl cad          Screening mammography, bilateral (2-view study of each breast
   G0204          No Change       Dx mammo incl cad bi           Diagnostic mammography, including computer-aided detection (c
   G0206          No Change       Dx mammo incl cad uni          Diagnostic mammography, including computer-aided detection (c
   G0219          No Change       Pet img wholbod melano nonco   Pet imaging whole body; melanoma for non-covered indications
   G0235          No Change       Pet not otherwise specified    Pet imaging, any site, not otherwise specified
   G0237          No Change       Therapeutic procd strg endur   Therapeutic procedures to increase strength or endurance of r
   G0238          No Change       Oth resp proc, indiv           Therapeutic procedures to improve respiratory function, other
   G0239          No Change       Oth resp proc, group           Therapeutic procedures to improve respiratory function or inc
   G0245          No Change       Initial foot exam pt lops      Initial physician evaluation and management of a diabetic pat
   G0246          No Change       Followup eval of foot pt lop   Follow-up physician evaluation and management of a diabetic p
   G0247          No Change       Routine footcare pt w lops     Routine foot care by a physician of a diabetic patient with d
   G0248          No Change       Demonstrate use home inr mon   Demonstration, prior to initiation of home inr monitoring, fo
   G0249          No Change       Provide inr test mater/equip   Provision of test materials and equipment for home inr monito
   G0250          No Change       Md inr test revie inter mgmt   Physician review, interpretation, and patient management of h
   G0251          No Change       Linear acc based stero radio   Linear accelerator based stereotactic radiosurgery, delivery
   G0252          No Change       Pet imaging initial dx         Pet imaging, full and partial-ring pet scanners only, for ini
   G0255          No Change       Current percep threshold tst   Current perception threshold/sensory nerve conduction test, (
   G0257          No Change       Unsched dialysis esrd pt hos   Unscheduled or emergency dialysis treatment for an esrd patie
   G0259          No Change       Inject for sacroiliac joint    Injection procedure for sacroiliac joint; arthrography
   G0260          No Change       Inj for sacroiliac jt anesth   Injection procedure for sacroiliac joint; provision of anesth
   G0268          No Change       Removal of impacted wax md     Removal of impacted cerumen (one or both ears) by physician o
   G0269          No Change       Occlusive device in vein art   Placement of occlusive device into either a venous or arteria
   G0270          No Change       Mnt subs tx for change dx      Medical nutrition therapy; reassessment and subsequent interv
   G0271          No Change       Group mnt 2 or more 30 mins    Medical nutrition therapy, reassessment and subsequent interv
   G0276          No Change       Pild/placebo control clin tr   Blinded procedure for lumbar stenosis, percutaneous image-gui
   G0277          No Change       Hbot, full body chamber, 30m   Hyperbaric oxygen under pressure, full body chamber, per 30 m
   G0278          No Change       Iliac art angio,cardiac cath   Iliac and/or femoral artery angiography, non-selective, bilat
   G0279          No Change       Tomosynthesis, mammo           Diagnostic digital breast tomosynthesis, unilateral or bilate
   G0281          No Change       Elec stim unattend for press   Electrical stimulation, (unattended), to one or more areas, f
   G0282          No Change       Elect stim wound care not pd   Electrical stimulation, (unattended), to one or more areas, f
   G0283          No Change       Elec stim other than wound     Electrical stimulation (unattended), to one or more areas for
   G0288          No Change       Recon, cta for surg plan       Reconstruction, computed tomographic angiography of aorta for
   G0289          No Change       Arthro, loose body + chondro   Arthroscopy, knee, surgical, for removal of loose body, forei
   G0293          No Change       Non-cov surg proc,clin trial   Noncovered surgical procedure(s) using conscious sedation, re
   G0294          No Change       Non-cov proc, clinical trial   Noncovered procedure(s) using either no anesthesia or local a
   G0295          No Change       Electromagnetic therapy onc    Electromagnetic therapy, to one or more areas, for wound care
   G0296          No Change       Visit to determ ldct elig      Counseling visit to discuss need for lung cancer screening us
   G0297          No Change       Ldct for lung ca screen        Low dose ct scan (ldct) for lung cancer screening
   G0299          No Change       Hhs/hospice of rn ea 15 min    Direct skilled nursing services of a registered nurse (rn) in
   G0300          No Change       Hhs/hospice of lpn ea 15 min   Direct skilled nursing services of a licensed practical nurse
   G0302          No Change       Pre-op service lvrs complete   Pre-operative pulmonary surgery services for preparation for
   G0303          No Change       Pre-op service lvrs 10-15dos   Pre-operative pulmonary surgery services for preparation for
   G0304          No Change       Pre-op service lvrs 1-9 dos    Pre-operative pulmonary surgery services for preparation for
   G0305          No Change       Post op service lvrs min 6     Post-discharge pulmonary surgery services after lvrs, minimum
   G0306          No Change       Cbc/diffwbc w/o platelet       Complete cbc, automated (hgb, hct, rbc, wbc, without platelet
   G0307          No Change       Cbc without platelet           Complete (cbc), automated (hgb, hct, rbc, wbc; without platel
   G0328          No Change       Fecal blood scrn immunoassay   Colorectal cancer screening; fecal occult blood test, immunoa
   G0329          No Change       Electromagntic tx for ulcers   Electromagnetic therapy, to one or more areas for chronic sta
   G0333          No Change       Dispense fee initial 30 day    Pharmacy dispensing fee for inhalation drug(s); initial 30-da
   G0337          No Change       Hospice evaluation preelecti   Hospice evaluation and counseling services, pre-election
   G0339          No Change       Robot lin-radsurg com, first   Image-guided robotic linear accelerator-based stereotactic ra
   G0340          No Change       Robt lin-radsurg fractx 2-5    Image-guided robotic linear accelerator-based stereotactic ra
   G0341          No Change       Percutaneous islet celltrans   Percutaneous islet cell transplant, includes portal vein cath
   G0342          No Change       Laparoscopy islet cell trans   Laparoscopy for islet cell transplant, includes portal vein c
   G0343          No Change       Laparotomy islet cell transp   Laparotomy for islet cell transplant, includes portal vein ca
   G0364          No Change       Bone marrow aspirate &biopsy   Bone marrow aspiration performed with bone marrow biopsy thro
   G0365          No Change       Vessel mapping hemo access     Vessel mapping of vessels for hemodialysis access (services f
   G0372          No Change       Md service required for pmd    Physician service required to establish and document the need
   G0378          No Change       Hospital observation per hr    Hospital observation service, per hour
   G0379          No Change       Direct refer hospital observ   Direct admission of patient for hospital observation care
   G0380          No Change       Lev 1 hosp type b ed visit     Level 1 hospital emergency department visit provided in a typ
   G0381          No Change       Lev 2 hosp type b ed visit     Level 2 hospital emergency department visit provided in a typ
   G0382          No Change       Lev 3 hosp type b ed visit     Level 3 hospital emergency department visit provided in a typ
   G0383          No Change       Lev 4 hosp type b ed visit     Level 4 hospital emergency department visit provided in a typ
   G0384          No Change       Lev 5 hosp type b ed visit     Level 5 hospital emergency department visit provided in a typ
   G0389          No Change       Ultrasound exam aaa screen     Ultrasound b-scan and/or real time with image documentation;
   G0390          No Change       Trauma respons w/hosp criti    Trauma response team associated with hospital critical care s
   G0396          No Change       Alcohol/subs interv 15-30mn    Alcohol and/or substance (other than tobacco) abuse structure
   G0397          No Change       Alcohol/subs interv >30 min    Alcohol and/or substance (other than tobacco) abuse structure
   G0398          No Change       Home sleep test/type 2 porta   Home sleep study test (hst) with type ii portable monitor, un
   G0399          No Change       Home sleep test/type 3 porta   Home sleep test (hst) with type iii portable monitor, unatten
   G0400          No Change       Home sleep test/type 4 porta   Home sleep test (hst) with type iv portable monitor, unattend
   G0402          No Change       Initial preventive exam        Initial preventive physical examination; face-to-face visit,
   G0403          No Change       Ekg for initial prevent exam   Electrocardiogram, routine ecg with 12 leads; performed as a
   G0404          No Change       Ekg tracing for initial prev   Electrocardiogram, routine ecg with 12 leads; tracing only, w
   G0405          No Change       Ekg interpret & report preve   Electrocardiogram, routine ecg with 12 leads; interpretation
   G0406          No Change       Inpt/tele follow up 15         Follow-up inpatient consultation, limited, physicians typical
   G0407          No Change       Inpt/tele follow up 25         Follow-up inpatient consultation, intermediate, physicians ty
   G0408          No Change       Inpt/tele follow up 35         Follow-up inpatient consultation, complex, physicians typical
   G0409          No Change       Corf related serv 15 mins ea   Social work and psychological services, directly relating to
   G0410          No Change       Grp psych partial hosp 45-50   Group psychotherapy other than of a multiple-family group, in
   G0411          No Change       Inter active grp psych parti   Interactive group psychotherapy, in a partial hospitalization
   G0412          No Change       Open tx iliac spine uni/bil    Open treatment of iliac spine(s), tuberosity avulsion, or ili
   G0413          No Change       Pelvic ring fracture uni/bil   Percutaneous skeletal fixation of posterior pelvic bone fract
   G0414          No Change       Pelvic ring fx treat int fix   Open treatment of anterior pelvic bone fracture and/or disloc
   G0415          No Change       Open tx post pelvic fxcture    Open treatment of posterior pelvic bone fracture and/or dislo
   G0416          No Change       Prostate biopsy, any mthd      Surgical pathology, gross and microscopic examinations, for p
   G0417          No Change       Sat biopsy prostate 21-40      Surgical pathology, gross and microscopic examination, for pr
   G0418          No Change       Sat biopsy prostate 41-60      Surgical pathology, gross and microscopic examination, for pr
   G0419          No Change       Sat biopsy prostate: >60       Surgical pathology, gross and microscopic examination, for pr
   G0420          No Change       Ed svc ckd ind per session     Face-to-face educational services related to the care of chro
   G0421          No Change       Ed svc ckd grp per session     Face-to-face educational services related to the care of chro
   G0422          No Change       Intens cardiac rehab w/exerc   Intensive cardiac rehabilitation; with or without continuous
   G0423          No Change       Intens cardiac rehab no exer   Intensive cardiac rehabilitation; with or without continuous
   G0424          No Change       Pulmonary rehab w exer         Pulmonary rehabilitation, including exercise (includes monito
   G0425          No Change       Inpt/ed teleconsult30          Telehealth consultation, emergency department or initial inpa
   G0426          No Change       Inpt/ed teleconsult50          Telehealth consultation, emergency department or initial inpa
   G0427          No Change       Inpt/ed teleconsult70          Telehealth consultation, emergency department or initial inpa
   G0428          No Change       Collagen meniscus implant      Collagen meniscus implant procedure for filling meniscal defe
   G0429          No Change       Dermal filler injection(s)     Dermal filler injection(s) for the treatment of facial lipody
   G0431          No Change       Drug screen multiple class     Drug screen, qualitative; multiple drug classes by high compl
   G0432          No Change       Eia hiv-1/hiv-2 screen         Infectious agent antibody detection by enzyme immunoassay (ei
   G0433          No Change       Elisa hiv-1/hiv-2 screen       Infectious agent antibody detection by enzyme-linked immunoso
   G0434          No Change       Drug screen multi drug class   Drug screen, other than chromatographic; any number of drug c
   G0435          No Change       Oral hiv-1/hiv-2 screen        Infectious agent antibody detection by rapid antibody test, h
   G0436          No Change       Tobacco-use counsel 3-10 min   Smoking and tobacco cessation counseling visit for the asympt
   G0437          No Change       Tobacco-use counsel>10min      Smoking and tobacco cessation counseling visit for the asympt
   G0438          No Change       Ppps, initial visit            Annual wellness visit; includes a personalized prevention pla
   G0439          No Change       Ppps, subseq visit             Annual wellness visit, includes a personalized prevention pla
   G0442          No Change       Annual alcohol screen 15 min   Annual alcohol misuse screening, 15 minutes
   G0443          No Change       Brief alcohol misuse counsel   Brief face-to-face behavioral counseling for alcohol misuse,
   G0444          No Change       Depression screen annual       Annual depression screening, 15 minutes
   G0445          No Change       High inten beh couns std 30m   High intensity behavioral counseling to prevent sexually tran
   G0446          No Change       Intens behave ther cardio dx   Annual, face-to-face intensive behavioral therapy for cardiov
   G0447          No Change       Behavior counsel obesity 15m   Face-to-face behavioral counseling for obesity, 15 minutes
   G0448          No Change       Place perm pacing cardiovert   Insertion or replacement of a permanent pacing cardioverter-d
   G0451          No Change       Devlopment test interpt&rep    Development testing, with interpretation and report, per stan
   G0452          No Change       Molecular pathology interpr    Molecular pathology procedure; physician interpretation and r
   G0453          No Change       Cont intraop neuro monitor     Continuous intraoperative neurophysiology monitoring, from ou
   G0454          No Change       Md document visit by npp       Physician documentation of face-to-face visit for durable med
   G0455          No Change       Fecal microbiota prep instil   Preparation with instillation of fecal microbiota by any meth
   G0456          No Change       Neg pre wound <=50 sq cm       Negative pressure wound therapy, (e.g. vacuum assisted draina
   G0457          No Change       Neg pres wound >50 sq cm       Negative pressure wound therapy, (e.g. vacuum assisted draina
   G0458          No Change       Ldr prostate brachy comp rat   Low dose rate (ldr) prostate brachytherapy services, composit
   G0459          No Change       Telehealth inpt pharm mgmt     Inpatient telehealth pharmacologic management, including pres
   G0460          No Change       Autologous prp for ulcers      Autologous platelet rich plasma for chronic wounds/ulcers, in
   G0461          No Change       Immunohisto/cyto chem 1st st   Immunohistochemistry or immunocytochemistry, per specimen; fi
   G0462          No Change       Immunohisto/cyto chem add      Immunohistochemistry or immunocytochemistry, per specimen; ea
   G0463          No Change       Hospital outpt clinic visit    Hospital outpatient clinic visit for assessment and managemen
   G0464          No Change       Colorec ca scr, sto bas dna    Colorectal cancer screening; stool-based dna and fecal occult
   G0466          No Change       Fqhc visit new patient         Federally qualified health center (fqhc) visit, new patient;
   G0467          No Change       Fqhc visit, estab pt           Federally qualified health center (fqhc) visit, established p
   G0468          No Change       Fqhc visit, ippe or awv        Federally qualified health center (fqhc) visit, ippe or awv;
   G0469          No Change       Fqhc visit, mh new pt          Federally qualified health center (fqhc) visit, mental health
   G0470          No Change       Fqhc visit, mh estab pt        Federally qualified health center (fqhc) visit, mental health
   G0471          No Change       Ven blood coll snf/hha         Collection of venous blood by venipuncture or urine sample by
   G0472          No Change       Hep c screen high risk/other   Hepatitis c antibody screening, for individual at high risk a
   G0473          No Change       Group behave couns 2-10        Face-to-face behavioral counseling for obesity, group (2-10),
   G0475          No Change       Hiv combination assay          Hiv antigen/antibody, combination assay, screening
   G0476          No Change       Hpv combo assay ca screen      Infectious agent detection by nucleic acid (dna or rna); huma
   G0477          No Change       Drug test presump optical      Drug test(s), presumptive, any number of drug classes; any nu
   G0478          No Change       Drug test presump opt inst     Drug test(s), presumptive, any number of drug classes; any nu
   G0479          No Change       Drug test presump not opt      Drug test(s), presumptive, any number of drug classes; any nu
   G0480          No Change       Drug test def 1-7 classes      Drug test(s), definitive, utilizing (1) drug identification m
   G0481          No Change       Drug test def 8-14 classes     Drug test(s), definitive, utilizing (1) drug identification m
   G0482          No Change       Drug test def 15-21 classes    Drug test(s), definitive, utilizing (1) drug identification m
   G0483          No Change       Drug test def 22+ classes      Drug test(s), definitive, utilizing (1) drug identification m
   G0490          No Change       Home visit rn, lpn by rhc/fq   Face-to-face home health nursing visit by a rural health clin
   G0491          No Change       Dialysis acu kidney no esrd    Dialysis procedure at a medicare certified esrd facility for
   G0492          No Change       Md/oth eval acut kid no esrd   Dialysis procedure with single evaluation by a physician or o
   G0493          No Change       Rn care ea 15 min hh/hospice   Skilled services of a registered nurse (rn) for the observati
   G0494          No Change       Lpn care ea 15min hh/hospice   Skilled services of a licensed practical nurse (lpn) for the
   G0495          No Change       Rn care train/edu in hh        Skilled services of a registered nurse (rn), in the training
   G0496          No Change       Lpn care train/edu in hh       Skilled services of a licensed practical nurse (lpn), in the
   G0498          No Change       Chemo extend iv infus w/pump   Chemotherapy administration, intravenous infusion technique;
   G0500          No Change       Mod sedat endo service >5yrs   Moderate sedation services provided by the same physician or
   G0501          No Change       Resource-inten svc during ov   Resource-intensive services for patients for whom the use of
   G0502          No Change       Init psych care manag, 70min   Initial psychiatric collaborative care management, first 70 m
   G0503          No Change       Subseq  psych care man,60mi    Subsequent psychiatric collaborative care management, first 6
   G0504          No Change       Init/sub psych care add 30 m   Initial or subsequent psychiatric collaborative care manageme
   G0505          No Change       Cog/func assessment  outpt     Cognition and functional assessment using standardized instru
   G0506          No Change       Comp asses care plan ccm svc   Comprehensive assessment of and care planning for patients re
   G0507          No Change       Care manage serv minimum 20    Care management services for behavioral health conditions, at
   G0508          No Change       Crit care telehea consult 60   Telehealth consultation, critical care, initial , physicians
   G0509          No Change       Crit care telehea consult 50   Telehealth consultation, critical care, subsequent, physician
   G0511          No Change       Ccm/bhi by rhc/fqhc 20min mo   Rural health clinic or federally qualified health center (rhc
   G0512          No Change       Cocm by rhc/fqhc 60 min mo     Rural health clinic or federally qualified health center (rhc
   G0513          No Change       Prolong prev svcs, first 30m   Prolonged preventive service(s) (beyond the typical service t
   G0514          No Change       Prolong prev svcs, addl 30m    Prolonged preventive service(s) (beyond the typical service t
   G0515          No Change       Cognitive skills development   Development of cognitive skills to improve attention, memory,
   G0517          No Change       Remove drug implant            Removal of non-biodegradable drug delivery implants, 4 or mor
   G0518          No Change       Remove w insert drug implant   Removal with reinsertion, non-biodegradable drug delivery imp
   G0659          No Change       Drug test def simple all cl    Drug test(s), definitive, utilizing drug identification metho
   G0908          No Change       Hgb > 12 g/dl                  Most recent hemoglobin (hgb) level > 12.0 g/dl
   G0909          No Change       Hbg not doc                    Hemoglobin level measurement not documented, reason not given
   G0910          No Change       Hgb <= 12 g/dl                 Most recent hemoglobin level <= 12.0 g/dl
   G0913          No Change       Improve visual funct           Improvement in visual function achieved within 90 days follow
   G0914          No Change       Survey not complete            Patient care survey was not completed by patient
   G0915          No Change       No improve visual funct        Improvement in visual function not achieved within 90 days fo
   G0916          No Change       Satisfy with care              Satisfaction with care achieved within 90 days following cata
   G0917          No Change       Satisfy survey not complete    Patient satisfaction survey was not completed by patient
   G0918          No Change       No satisfy with care           Satisfaction with care not achieved within 90 days following
   G0919          No Change       Flu immunize not avail         Influenza immunization ordered or recommended (to be given at
   G0920          No Change       Type loc act doc               Type, anatomic location, and activity all documented
   G0921          No Change       Doc pt reas no assess          Documentation of patient reason(s) for not being able to asse
   G0922          No Change       Type loc act not doc           No documentation of disease type, anatomic location, and acti
   G3001          No Change       Admin + supply, tositumomab    Administration and supply of tositumomab, 450 mg
   G6001          No Change       Echo guidance radiotherapy     Ultrasonic guidance for placement of radiation therapy fields
   G6002          No Change       Stereoscopic x-ray guidance    Stereoscopic x-ray guidance for localization of target volume
   G6003          No Change       Radiation treatment delivery   Radiation treatment delivery, single treatment area,single po
   G6004          No Change       Radiation treatment delivery   Radiation treatment delivery, single treatment area,single po
   G6005          No Change       Radiation treatment delivery   Radiation treatment delivery, single treatment area,single po
   G6006          No Change       Radiation treatment delivery   Radiation treatment delivery, single treatment area,single po
   G6007          No Change       Radiation treatment delivery   Radiation treatment delivery, 2 separate treatment areas, 3 o
   G6008          No Change       Radiation treatment delivery   Radiation treatment delivery, 2 separate treatment areas, 3 o
   G6009          No Change       Radiation treatment delivery   Radiation treatment delivery, 2 separate treatment areas, 3 o
   G6010          No Change       Radiation treatment delivery   Radiation treatment delivery, 2 separate treatment areas, 3 o
   G6011          No Change       Radiation treatment delivery   Radiation treatment delivery,3 or more separate treatment are
   G6012          No Change       Radiation treatment delivery   Radiation treatment delivery,3 or more separate treatment are
   G6013          No Change       Radiation treatment delivery   Radiation treatment delivery,3 or more separate treatment are
   G6014          No Change       Radiation treatment delivery   Radiation treatment delivery,3 or more separate treatment are
   G6015          No Change       Radiation tx delivery imrt     Intensity modulated treatment delivery, single or multiple fi
   G6016          No Change       Delivery comp imrt             Compensator-based beam modulation treatment delivery of inver
   G6017          No Change       Intrafraction track motion     Intra-fraction localization and tracking of target or patient
   G6018          No Change       Ileoscopy w/stent              Ileoscopy, through stoma; with transendoscopic stent placemen
   G6019          No Change       Colonoscopy lesion removal     Colonoscopy through stoma; with ablation of tumor(s), polyp(s
   G6020          No Change       Colonoscopy w/stent            Colonoscopy through stoma; with transendoscopic stent placeme
   G6021          No Change       Unlisted px small intestine    Unlisted procedure, intestine
   G6022          No Change       Sigmoidoscopy w/ablate tumr    Sigmoidoscopy, flexible; with ablation of tumor(s), polyp(s),
   G6023          No Change       Sigmoidoscopy w/stent          Sigmoidoscopy, flexible; with transendoscopic stent placement
   G6024          No Change       Lesion removal colonoscopy     Colonoscopy, flexible; proximal to splenic flexure; with abla
   G6025          No Change       Colonoscopy w/stent            Colonoscopy, flexible, proximal to splenic flexure; with tran
   G6027          No Change       Anoscopy hra w/spec collect    Anoscopy, high resolution (hra) (with magnification and chemi
   G6028          No Change       Anoscopy hra w/biopsy          Anoscopy, high resolution (hra) (with magnification and chemi
   G6030          No Change       Assay of amitriptyline         Amitriptyline
   G6031          No Change       Assay of benzodiazepines       Benzodiazepines
   G6032          No Change       Assay of desipramine           Desipramine
   G6034          No Change       Assay of doxepin               Doxepin
   G6035          No Change       Assay of gold                  Gold
   G6036          No Change       Assay of imipramine            Assay of imipramine
   G6037          No Change       Assay of nortiptyline          Nortriptyline
   G6038          No Change       Assay of salicylate            Salicylate
   G6039          No Change       Assay of acetaminophen         Acetaminophen
   G6040          No Change       Assay of ethanol               Alcohol (ethanol); any specimen except breath
   G6041          No Change       Assay of urine alkaloids       Alkaloids, urine, quantitative
   G6042          No Change       Assay of amphetamines          Amphetamine or methamphetamine
   G6043          No Change       Assay of barbiturates          Barbiturates, not elsewhere specified
   G6044          No Change       Assay of cocaine               Cocaine or metabolite
   G6045          No Change       Assay of dihydrocodeinone      Dihydrocodeinone
   G6046          No Change       Assay of dihydromorphinone     Dihydromorphinone
   G6047          No Change       Assay of dihydrotestosterone   Dihydrotestosterone
   G6048          No Change       Assay of dimethadione          Dimethadione
   G6049          No Change       Asssay of epiandrosterone      Epiandrosterone
   G6050          No Change       Assay of ethchlorvynol         Ethchlorvynol
   G6051          No Change       Assay of flurazepam            Flurazepam
   G6052          No Change       Assay of meprobamate           Meprobamate
   G6053          No Change       Assay of methadone             Methadone
   G6054          No Change       Assay of methsuximide          Methsuximide
   G6055          No Change       Assay of nicotine              Nicotine
   G6056          No Change       Assay of opiates               Opiate(s), drug and metabolites, each procedure
   G6057          No Change       Assay of phenothiazine         Phenothiazine
   G6058          No Change       Drug confirmation              Drug confirmation, each procedure
   G8126          No Change       Pt treat w/antidepress12wks    Patient with a diagnosis of major depression documented as be
   G8127          No Change       Pt not treat w/antidepres12w   Patient with a diagnosis of major depression not documented a
   G8128          No Change       Pt inelig for antidepres med   Clinician documented that patient was not an eligible candida
   G8395          No Change       Lvef>=40% doc normal or mild   Left ventricular ejection fraction (lvef) >= 40% or documenta
   G8396          No Change       Lvef not performed             Left ventricular ejection fraction (lvef) not performed or do
   G8397          No Change       Dil macula/fundus exam/w doc   Dilated macular or fundus exam performed, including documenta
   G8398          No Change       Dil macular/fundus not perfo   Dilated macular or fundus exam not performed
   G8399          No Change       Pt w/dxa results document      Patient with documented results of a central dual-energy x-ra
   G8400          No Change       Pt w/dxa no results doc        Patient with central dual-energy x-ray absorptiometry (dxa) r
   G8401          No Change       Pt inelig osteo screen measu   Clinician documented that patient was not an eligible candida
   G8404          No Change       Low extemity neur exam docum   Lower extremity neurological exam performed and documented
   G8405          No Change       Low extemity neur not perfor   Lower extremity neurological exam not performed
   G8406          No Change       Pt inelig lower extrem neuro   Clinician documented that patient was not an eligible candida
   G8410          No Change       Eval on foot documented        Footwear evaluation performed and documented
   G8415          No Change       Eval on foot not performed     Footwear evaluation was not performed
   G8416          No Change       Pt inelig footwear evaluatio   Clinician documented that patient was not an eligible candida
   G8417          No Change       Calc bmi abv up param f/u      Bmi is documented above normal parameters and a follow-up pla
   G8418          No Change       Calc bmi blw low param f/u     Bmi is documented below normal parameters and a follow-up pla
   G8419          No Change       Calc bmi out nrm param nof/u   Bmi documented outside normal parameters, no follow-up plan d
   G8420          No Change       Calc bmi norm parameters       Bmi is documented within normal parameters and no follow-up p
   G8421          No Change       Bmi not calculated             Bmi not documented and no reason is given
   G8422          No Change       Pt inelig bmi calculation      Bmi not documented, documentation the patient is not eligible
   G8427          No Change       Docrev cur meds by elig clin   Eligible clinician attests to documenting in the medical reco
   G8428          No Change       Cur meds not document          Current list of medications not documented as obtained, updat
   G8430          No Change       Ec at doc medrec pt not elig   Eligible clinician attests to documenting in the medical reco
   G8431          No Change       Pos clin depres scrn f/u doc   Screening for depression is documented as being positive and
   G8432          No Change       Dep scr not doc, rng           Depression screening not documented, reason not given
   G8433          No Change       Scr for dep not cpt doc rsn    Screening for depression not completed, documented reason
   G8442          No Change       Doc pain as nt perf, not elg   Pain assessment not documented as being performed, documentat
   G8450          No Change       Beta-bloc rx pt w/abn lvef     Beta-blocker therapy prescribed
   G8451          No Change       Pt w/abn lvef inelig b-bloc    Beta-blocker therapy for lvef < 40% not prescribed for reason
   G8452          No Change       Pt w/abn lvef b-bloc no rx     Beta-blocker therapy not prescribed
   G8458          No Change       Pt inelig geno no antvir tx    Clinician documented that patient is not an eligible candidat
   G8460          No Change       Pt inelig rna no antvir tx     Clinician documented that patient is not an eligible candidat
   G8461          No Change       Pt rec antivir treat hep c     Patient receiving antiviral treatment for hepatitis c during
   G8464          No Change       Pt inelig; lo to no dter rsk   Clinician documented that prostate cancer patient is not an e
   G8465          No Change       High risk recurrence pro ca    High or very high risk of recurrence of prostate cancer
   G8473          No Change       Ace/arb thxpy rx'd             Angiotensin converting enzyme (ace) inhibitor or angiotensin
   G8474          No Change       Ace/arb not rx'd; doc reas     Angiotensin converting enzyme (ace) inhibitor or angiotensin
   G8475          No Change       Ace/arb thxpy not rx'd         Angiotensin converting enzyme (ace) inhibitor or angiotensin
   G8476          No Change       Bp sys <140 and dias <90       Most recent blood pressure has a systolic measurement of < 14
   G8477          No Change       Bp sys>=140 and/or dias >=90   Most recent blood pressure has a systolic measurement of >= 1
   G8478          No Change       Bp not performed/doc           Blood pressure measurement not performed or documented, reaso
   G8482          No Change       Flu immunize order/admin       Influenza immunization administered or previously received
   G8483          No Change       Flu imm no admin doc rea       Influenza immunization was not administered for reasons docum
   G8484          No Change       Flu immunize no admin          Influenza immunization was not administered, reason not given
   G8485          No Change       Report, diabetes measures      I intend to report the diabetes mellitus (dm) measures group
   G8486          No Change       Report, prev care measures     I intend to report the preventive care measures group
   G8487          No Change       Report ckd measures            I intend to report the chronic kidney disease (ckd) measures
   G8489          No Change       Cad measures grp               I intend to report the coronary artery disease (cad) measures
   G8490          No Change       Ra measures grp                I intend to report the rheumatoid arthritis (ra) measures gro
   G8491          No Change       Hiv/aids measures grp          I intend to report the hiv/aids measures group
   G8492          No Change       Periop care measures grp       I intend to report the perioperative care measures group
   G8493          No Change       Back pain measures grp         I intend to report the back pain measures group
   G8494          No Change       Dm meas qual act perform       All quality actions for the applicable measures in the diabet
   G8495          No Change       Ckd meas qual act perform      All quality actions for the applicable measures in the chroni
   G8496          No Change       Prev care mg qual act perfrm   All quality actions for the applicable measures in the preven
   G8497          No Change       Cabg meas qual act perform     All quality actions for the applicable measures in the corona
   G8498          No Change       Cad meas qual act perform      All quality actions for the applicable measures in the corona
   G8499          No Change       Ra meas qual act perform       All quality actions for the applicable measures in the rheuma
   G8500          No Change       Hiv meas qual act perform      All quality actions for the applicable measures in the hiv/ai
   G8501          No Change       Perio meas qual act perform    All quality actions for the applicable measures in the periop
   G8502          No Change       Back pain mg qual act perfrm   All quality actions for the applicable measures in the back p
   G8506          No Change       Pt rec ace/arb                 Patient receiving angiotensin converting enzyme (ace) inhibit
   G8509          No Change       Pos pain assess no f/u doc     Pain assessment documented as positive using a standardized t
   G8510          No Change       Scr dep neg, no plan reqd      Screening for depression is documented as negative, a follow-
   G8511          No Change       Scr dep pos, no plan doc rng   Screening for depression documented as positive, follow-up pl
   G8530          No Change       Auto av fistula recd           Autogenous av fistula received
   G8531          No Change       Pt inelig; auto av fistula     Clinician documented that patient was not an eligible candida
   G8532          No Change       No auto av fistula; no reas    Clinician documented that patient received vascular access ot
   G8535          No Change       Eld maltreatment not doc       Elder maltreatment screen not documented; documentation that
   G8536          No Change       No doc elder mal scrn          No documentation of an elder maltreatment screen, reason not
   G8539          No Change       Doc funct and care plan        Functional outcome assessment documented as positive using a
   G8540          No Change       Foa not doc as being perf      Functional outcome assessment not documented as being perform
   G8541          No Change       No doc cur funct assess        Functional outcome assessment using a standardized tool not d
   G8542          No Change       Doc funct no deficiencies      Functional outcome assessment using a standardized tool is do
   G8543          No Change       Cur funct asses; no care pln   Documentation of a positive functional outcome assessment usi
   G8544          No Change       Cabg measures grp              I intend to report the coronary artery bypass graft (cabg) me
   G8545          No Change       Hepc measures grp              I intend to report the hepatitis c measures group
   G8547          No Change       Ivd measures grp               I intend to report the ischemic vascular disease (ivd) measur
   G8548          No Change       Hf measures grp                I intend to report the heart failure (hf) measures group
   G8549          No Change       Hepc mg qual act perform       All quality actions for the applicable measures in the hepati
   G8551          No Change       Hf mg qual act perform         All quality actions for the applicable measures in the heart
   G8552          No Change       Ivd mg qual act perform        All quality actions for the applicable measures in the ischem
   G8559          No Change       Pt ref doc oto eval            Patient referred to a physician (preferably a physician with
   G8560          No Change       Pt hx act drain prev 90 days   Patient has a history of active drainage from the ear within
   G8561          No Change       Pt inelig for ref oto eval     Patient is not eligible for the referral for otologic evaluat
   G8562          No Change       Pt no hx act drain 90 d        Patient does not have a history of active drainage from the e
   G8563          No Change       Pt no ref oto reas no spec     Patient not referred to a physician (preferably a physician w
   G8564          No Change       Pt ref oto eval                Patient was referred to a physician (preferably a physician w
   G8565          No Change       Ver doc hear loss              Verification and documentation of sudden or rapidly progressi
   G8566          No Change       Pt inelig ref oto eval         Patient is not eligible for the "referral for otologic evalua
   G8567          No Change       Pt no doc hear loss            Patient does not have verification and documentation of sudde
   G8568          No Change       Pt no ref otolo no spec        Patient was not referred to a physician (preferably a physici
   G8569          No Change       Prol intubation req            Prolonged postoperative intubation (> 24 hrs) required
   G8570          No Change       No prol intub req              Prolonged postoperative intubation (> 24 hrs) not required
   G8571          No Change       Ster wd ifx 30 d postop        Development of deep sternal wound infection/mediastinitis wit
   G8572          No Change       No ster wd ifx                 No deep sternal wound infection/mediastinitis
   G8573          No Change       Stk cabg                       Stroke following isolated cabg surgery
   G8574          No Change       No strk cabg                   No stroke following isolated cabg surgery
   G8575          No Change       Postop ren fail                Developed postoperative renal failure or required dialysis
   G8576          No Change       No postop ren fail             No postoperative renal failure/dialysis not required
   G8577          No Change       Reop req bld grft oth          Re-exploration required due to mediastinal bleeding with or w
   G8578          No Change       No reop req bld grft oth       Re-exploration not required due to mediastinal bleeding with
   G8579          No Change       Antplt med disch               Antiplatelet medication at discharge
   G8580          No Change       Antplt med contraind           Antiplatelet medication contraindicated
   G8581          No Change       No antplt med disch            No antiplatelet medication at discharge
   G8582          No Change       Bblock disch                   Beta-blocker at discharge
   G8583          No Change       Bblock contraind               Beta-blocker contraindicated
   G8584          No Change       No bblock disch                No beta-blocker at discharge
   G8585          No Change       Antilipid treat disch          Anti-lipid treatment at discharge
   G8586          No Change       Antlip disch contra            Anti-lipid treatment contraindicated
   G8587          No Change       No antlipid treat disch        No anti-lipid treatment at discharge
   G8593          No Change       Lipid pn results               Lipid profile results documented and reviewed (must include t
   G8594          No Change       No lipid prof perf             Lipid profile not performed, reason not given
   G8595          No Change       Ldl < 100                      Most recent ldl-c < 100 mg/dl
   G8597          No Change       Ldl >= 100                     Most recent ldl-c >= 100 mg/dl
   G8598          No Change       Asa/antiplat ther used         Aspirin or another antiplatelet therapy used
   G8599          No Change       No asa/antiplat ther use rng   Aspirin or another antiplatelet therapy not used, reason not
   G8600          No Change       Tpa initi w/in 3 hrs           Iv t-pa initiated within three hours (<= 180 minutes) of time
   G8601          No Change       No elig tpa init w/in 3 hrs    Iv t-pa not initiated within three hours (<= 180 minutes) of
   G8602          No Change       No tpa init w/in 3 hrs         Iv t-pa not initiated within three hours (<= 180 minutes) of
   G8627          No Change       Surg proc w/in 30 days         Surgical procedure performed within 30 days following catarac
   G8628          No Change       No surg proc w/in 30 days      Surgical procedure not performed within 30 days following cat
   G8629          No Change       Doc antibio order b/4 surg     Documentation of order for prophylactic parenteral antibiotic
   G8630          No Change       Doc antibio given b/4 surg     Documentation that administration of prophylactic parenteral
   G8631          No Change       Pt no elg 4 order antbi give   Clinician documented that patient was not an eligible candida
   G8632          No Change       Doc no antibi order b/4 surg   Prophylactic parenteral antibiotics were not ordered to be gi
   G8633          No Change       Pharm ther osteo rx            Pharmacologic therapy (other than minierals/vitamins) for ost
   G8634          No Change       Pt no elg phar ther osteo      Clinician documented patient not an eligible candidate to rec
   G8635          No Change       No pharm ther osteo rx         Pharmacologic therapy for osteoporosis was not prescribed, re
   G8645          No Change       Asthma measures grp            I intend to report the asthma measures group
   G8646          No Change       Asthma mg qual act perform     All quality actions for the applicable measures in the asthma
   G8682          No Change       Lvg test perf                  Lvf testing documented as being performed prior to discharge
   G8683          No Change       Pt not elig for lvf test       Lvf testing not performed prior to discharge or in the previo
   G8685          No Change       Lvf test not perf              Lvf testing not documented as being performed prior to discha
   G8694          No Change       Lvef <40%                      Left ventricular ejection fraction (lvef) < 40%
   G8696          No Change       Antithromb thx presc           Antithrombotic therapy prescribed at discharge
   G8697          No Change       Antithromb no presc doc reas   Antithrombotic therapy not prescribed for documented reasons
   G8698          No Change       Antithromb no presc no reas    Antithrombotic therapy was not prescribed at discharge, reaso
   G8699          No Change       Rehab ordered disch            Rehabilitation services (occupational, physical or speech) or
   G8700          No Change       Rehab not indicated disch      Rehabilitation services (occupational, physical or speech) no
   G8701          No Change       Rehab not ordered              Rehabilitation services were not ordered, reason not otherwis
   G8702          No Change       Antiobiotics 4 hr prior surg   Documentation that prophylactic antibiotics were given within
   G8703          No Change       Antibiotics not prior surg     Documentation that prophylactic antibiotics were neither give
   G8704          No Change       Ecg performed                  12-lead electrocardiogram (ecg) performed
   G8705          No Change       Med reas no ecg                Documentation of medical reason(s) for not performing a 12-le
   G8706          No Change       Pt reas no ecg                 Documentation of patient reason(s) for not performing a 12-le
   G8707          No Change       Ecg not performed              12-lead electrocardiogram (ecg) not performed, reason not giv
   G8708          No Change       Antibiotic not pres            Patient not prescribed or dispensed antibiotic
   G8710          No Change       Pt pres antibiotic             Patient prescribed or dispensed antibiotic
   G8711          No Change       Pres antibiotic                Prescribed or dispensed antibiotic
   G8712          No Change       Not pres antibiotic            Antibiotic not prescribed or dispensed
   G8713          No Change       Spkt/v great 1.2 kt/v          Spkt/v greater than or equal to 1.2 (single-pool clearance of
   G8714          No Change       Hemodialysis 3 times week      Hemodialysis treatment performed exactly three times per week
   G8717          No Change       Less 1.2 kt/v                  Spkt/v less than 1.2 (single-pool clearance of urea [kt] / vo
   G8718          No Change       Great 1.7 kt/v per week        Total kt/v greater than or equal to 1.7 per week (total clear
   G8720          No Change       Less 1.7 kt/v per week         Total kt/v less than 1.7 per week (total clearance of urea [k
   G8721          No Change       Pt, pn, hist grade doc         Pt category (primary tumor), pn category (regional lymph node
   G8722          No Change       Med reas pt, pn, not doc       Documentation of medical reason(s) for not including the pt c
   G8723          No Change       Spec sit not prim tumor        Specimen site is other than anatomic location of primary tumo
   G8724          No Change       Pt, pn, hist grade not doc     Pt category, pn category and histologic grade were not docume
   G8725          No Change       Lipid profile perf doc         Fasting lipid profile performed (triglycerides, ldl-c, hdl-c
   G8726          No Change       Doc reas no lipid profile      Clinician has documented reason for not performing fasting li
   G8728          No Change       Lipid profile not perf         Fasting lipid profile not performed, reason not given
   G8730          No Change       Pain doc pos and plan          Pain assessment documented as positive using a standardized t
   G8731          No Change       Pain neg no plan               Pain assessment using a standardized tool is documented as ne
   G8732          No Change       No doc of pain                 No documentation of pain assessment, reason not given
   G8733          No Change       Doc pos elder mal scrn plan    Elder maltreatment screen documented as positive and a follow
   G8734          No Change       Doc neg elder mal no plan      Elder maltreatment screen documented as negative, no follow-u
   G8735          No Change       Eld mal scrn pos no plan       Elder maltreatment screen documented as positive, follow-up p
   G8736          No Change       Ldl-c <100mg/dl                Most current ldl-c <100mg/dl
   G8737          No Change       Ldl-c >=100mg/dl               Most current ldl-c >=100mg/dl
   G8738          No Change       Lvef < 40%                     Left ventricular ejection fraction (lvef) < 40% or documentat
   G8739          No Change       Lvef >= 40%                    Left ventricular ejection fraction (lvef) >= 40% or documenta
   G8740          No Change       Lvef not perfrmd               Left ventricular ejection fraction (lvef) not performed or as
   G8751          No Change       Smkg status not assess         Smoking status and exposure to second hand smoke in the home
   G8752          No Change       Sys bp less 140                Most recent systolic blood pressure < 140 mmhg
   G8753          No Change       Sys bp > or = 140              Most recent systolic blood pressure >= 140 mmhg
   G8754          No Change       Dias bp less 90                Most recent diastolic blood pressure < 90 mmhg
   G8755          No Change       Dias bp > or = 90              Most recent diastolic blood pressure >= 90 mmhg
   G8756          No Change       No bp measure doc              No documentation of blood pressure measurement, reason not gi
   G8757          No Change       Copd mg qual act perform       All quality actions for the applicable measures in the chroni
   G8758          No Change       Ibd mg qual act perform        All quality actions for the applicable measures in the inflam
   G8759          No Change       Osa mg qual act perform        All quality actions for the applicable measures in the sleep
   G8761          No Change       Dementia mg qual act perform   All quality actions for the applicable measures in the dement
   G8762          No Change       Pd mg qual act perform         All quality actions for the applicable measures in the parkin
   G8763          No Change       Hyperten mg qual act perform   All quality actions for the applicable measures in the hypert
   G8764          No Change       Car prev mg qual act perform   All quality actions for the applicable measures in the cardio
   G8765          No Change       Cataract mg qual act perform   All quality actions for the applicable measures in the catara
   G8767          No Change       Lipid panel res doc rev        Lipid panel results documented and reviewed (must include tot
   G8768          No Change       Doc med reas no lipid profle   Documentation of medical reason(s) for not performing lipid p
   G8769          No Change       Lipid profile not perform      Lipid profile not performed, reason not given
   G8770          No Change       Urine protein test doc rev     Urine protein test result documented and reviewed
   G8771          No Change       Doc dx ckd                     Documentation of diagnosis of chronic kidney disease
   G8772          No Change       Doc med reas no urine protn    Documentation of medical reason(s) for not performing urine p
   G8773          No Change       No urine protein test          Urine protein test was not performed, reason not given
   G8774          No Change       Serum creatinine doc rev       Serum creatinine test result documented and reviewed
   G8775          No Change       Doc med reas no serum crtn     Documentation of medical reason(s) for not performing serum c
   G8776          No Change       No serum creatinine test       Serum creatinine test not performed, reason not given
   G8777          No Change       Diabetes screen                Diabetes screening test performed
   G8778          No Change       Doc med reas no diabete scrn   Documentation of medical reason(s) for not performing diabete
   G8779          No Change       No diabetes screen             Diabetes screening test not performed, reason not given
   G8780          No Change       Counsel diet phys activity     Counseling for diet and physical activity performed
   G8781          No Change       Doc med reas no counsel diet   Documentation of medical reason(s) for patient not receiving
   G8782          No Change       No counsel diet phys act       Counseling for diet and physical activity not performed, reas
   G8783          No Change       Bp scrn perf rec interval      Normal blood pressure reading documented, follow-up not requi
   G8784          No Change       Pt no elig for bp assess       Patient not eligible (e.g., documentation the patient is not
   G8785          No Change       Bp scrn no perf at interval    Blood pressure reading not documented, reason not given
   G8797          No Change       Specimen site not esophagus    Specimen site other than anatomic location of esophagus
   G8798          No Change       Specimen site not prostate     Specimen site other than anatomic location of prostate
   G8808          No Change       Ultrasound not perf, rng       Trans-abdominal or trans-vaginal ultrasound not performed, re
   G8809          No Change       Rh-immunoglobulin order        Rh-immunoglobulin (rhogam) ordered
   G8810          No Change       Doc reas no rh-immuno          Rh-immunoglobulin (rhogam) not ordered for reasons documented
   G8811          No Change       No rh-immunoglobulin order     Documentation rh-immunoglobulin (rhogam) was not ordered, rea
   G8815          No Change       Doc reas no statin therapy     Documented reason in the medical records for why the statin t
   G8816          No Change       Statin med pres at disch       Statin medication prescribed at discharge
   G8817          No Change       Doc reas no statin med disch   Statin therapy not prescribed at discharge, reason not given
   G8818          No Change       Pt disch to home by day#7      Patient discharge to home no later than post-operative day #7
   G8825          No Change       Pt not disch to home day#7     Patient not discharged to home by post-operative day #7
   G8826          No Change       Pt disch home day #2 evar      Patient discharge to home no later than post-operative day #2
   G8833          No Change       Pt not disch home day#2 evar   Patient not discharged to home by post-operative day #2 follo
   G8834          No Change       Pt disch home day #2 cea       Patient discharged to home no later than post-operative day #
   G8838          No Change       Not disch home by day #2       Patient not discharged to home by post-operative day #2 follo
   G8839          No Change       Sleep apnea assess             Sleep apnea symptoms assessed, including presence or absence
   G8840          No Change       Doc reas no sleep apnea        Documentation of reason(s) for not documenting an assessment
   G8841          No Change       No sleep apnea assess          Sleep apnea symptoms not assessed, reason not given
   G8842          No Change       Ahi or rdi initial dx          Apnea hypopnea index (ahi) or respiratory disturbance index (
   G8843          No Change       Doc reas no ahi or rdi         Documentation of reason(s) for not measuring an apnea hypopne
   G8844          No Change       No ahi or rdi initial dx       Apnea hypopnea index (ahi) or respiratory disturbance index (
   G8845          No Change       Pos airway press prescribed    Positive airway pressure therapy prescribed
   G8846          No Change       Mod or severe osa              Moderate or severe obstructive sleep apnea (apnea hypopnea in
   G8848          No Change       Mild osa                       Mild obstructive sleep apnea (apnea hypopnea index (ahi) or r
   G8849          No Change       Doc reas no pos air press      Documentation of reason(s) for not prescribing positive airwa
   G8850          No Change       No pap prescribed              Positive airway pressure therapy not prescribed, reason not g
   G8851          No Change       Adhere pos air press therapy   Objective measurement of adherence to positive airway pressur
   G8852          No Change       Pos air press prescribe        Positive airway pressure therapy prescribed
   G8853          No Change       Pos air press not prescribe    Positive airway pressure therapy not prescribed
   G8854          No Change       Reas no adhere pos air pres    Documentation of reason(s) for not objectively measuring adhe
   G8855          No Change       Pos air press adhere no perf   Objective measurement of adherence to positive airway pressur
   G8856          No Change       Ref for oto eval               Referral to a physician for an otologic evaluation performed
   G8857          No Change       No elig ref for oto eval       Patient is not eligible for the referral for otologic evaluat
   G8858          No Change       Not ref for oto eval           Referral to a physician for an otologic evaluation not perfor
   G8859          No Change       Corticosteroids 10mg 60 days   Patient receiving corticosteroids greater than or equal to 10
   G8860          No Change       Corticosteroid 10 mg 60 days   Patients who have received dose of corticosteroids greater th
   G8861          No Change       Dxa ordered for osteo          Within the past 2 years, central dual-energy x-ray absorptiom
   G8862          No Change       No corticostrd 10mg 60 days    Patients not receiving corticosteroids greater than or equal
   G8863          No Change       No assess bone loss            Patients not assessed for risk of bone loss, reason not given
   G8864          No Change       Pneumococcal vaccine admin     Pneumococcal vaccine administered or previously received
   G8865          No Change       Doc med reas no pneumococcal   Documentation of medical reason(s) for not administering or p
   G8866          No Change       Doc pt reas no pneumococcal    Documentation of patient reason(s) for not administering or p
   G8867          No Change       No pneumococcal admin          Pneumococcal vaccine not administered or previously received,
   G8868          No Change       1st course antitnf             Patients receiving a first course of anti-tnf therapy
   G8869          No Change       Doc immune hep b antitnf       Patient has documented immunity to hepatitis b and initiating
   G8870          No Change       Hepb admin 1st antitnf         Hepatitis b vaccine injection administered or previously rece
   G8871          No Change       No 1st antitnf                 Patient not receiving a first course of anti-tnf therapy
   G8872          No Change       Intraop image confirm excise   Excised tissue evaluated by imaging intraoperatively to confi
   G8873          No Change       Specimen not intraop image     Patients with needle localization specimens which are not ame
   G8874          No Change       Tissue not image intraop       Excised tissue not evaluated by imaging intraoperatively to c
   G8875          No Change       Breast cancer dx min invsive   Clinician diagnosed breast cancer preoperatively by a minimal
   G8876          No Change       Doc reas no min inv dx         Documentation of reason(s) for not performing minimally invas
   G8877          No Change       No brst cncr dx min invasive   Clinician did not attempt to achieve the diagnosis of breast
   G8878          No Change       Sent lymph node biopsy         Sentinel lymph node biopsy procedure performed
   G8879          No Change       Node neg inv brst cncr         Clinically node negative (t1n0m0 or t2n0m0) invasive breast c
   G8881          No Change       Brst cncr stage > t1n0m0       Stage of breast cancer is greater than t1n0m0 or t2n0m0
   G8882          No Change       No sent lymph node biopsy      Sentinel lymph node biopsy procedure not performed, reason no
   G8883          No Change       Rev, comm, track, doc biopsy   Biopsy results reviewed, communicated, tracked and documented
   G8884          No Change       Doc reas biopsy not review     Clinician documented reason that patient's biopsy results wer
   G8885          No Change       No rev, comm, track biopsy     Biopsy results not reviewed, communicated, tracked or documen
   G8886          No Change       Bp under control               Most recent blood pressure under control
   G8887          No Change       Doc med reas bp not control    Documentation of medical reason(s) for most recent blood pres
   G8888          No Change       Bp not under control           Most recent blood pressure not under control, results documen
   G8889          No Change       No doc bp                      No documentation of blood pressure measurement, reason not gi
   G8890          No Change       Ldl-c under control            Most recent ldl-c under control, results documented and revie
   G8891          No Change       Doc med reas no ldl-c contrl   Documentation of medical reason(s) for most recent ldl-c not
   G8892          No Change       Doc med reas no ldl-c test     Documentation of medical reason(s) for not performing ldl-c t
   G8893          No Change       Ldl-c not under control        Most recent ldl-c not under control, results documented and r
   G8894          No Change       Ldl-c not performed            Ldl-c not performed, reason not given
   G8895          No Change       Antrom prescribe               Oral aspirin or other antithrombotic therapy prescribed
   G8896          No Change       Doc med reas no antihtrom      Documentation of medical reason(s) for not prescribing oral a
   G8897          No Change       Antithrom not prescribe        Oral aspirin or other antithrombotic therapy was not prescrib
   G8898          No Change       Copd measures group            I intend to report the chronic obstructive pulmonary disease
   G8899          No Change       Inflammatory bowel dis mg      I intend to report the inflammatory bowel disease (ibd) measu
   G8900          No Change       Obstructive sleep apnea mg     I intend to report the sleep apnea measures group
   G8902          No Change       Dementia measures group        I intend to report the dementia measures group
   G8903          No Change       Parkinson's disease mg         I intend to report the parkinson's disease measures group
   G8904          No Change       Hypertension mg                I intend to report the hypertension (htn) measures group
   G8905          No Change       Cardiovascular prevention mg   I intend to report the cardiovascular prevention measures gro
   G8906          No Change       Cataract measures group        I intend to report the cataract measures group
   G8907          No Change       Pt doc no events on discharg   Patient documented not to have experienced any of the followi
   G8908          No Change       Pt doc w burn prior to d/c     Patient documented to have received a burn prior to discharge
   G8909          No Change       Pt doc no burn prior to d/c    Patient documented not to have received a burn prior to disch
   G8910          No Change       Pt doc to have fall in asc     Patient documented to have experienced a fall within asc
   G8911          No Change       Pt doc no fall in asc          Patient documented not to have experienced a fall within ambu
   G8912          No Change       Pt doc with wrong event        Patient documented to have experienced a wrong site, wrong si
   G8913          No Change       Pt doc no wrong event          Patient documented not to have experienced a wrong site, wron
   G8914          No Change       Pt trans to hosp post d/c      Patient documented to have experienced a hospital transfer or
   G8915          No Change       Pt not trans to hosp at d/c    Patient documented not to have experienced a hospital transfe
   G8916          No Change       Pt w iv ab given on time       Patient with preoperative order for iv antibiotic surgical si
   G8917          No Change       Pt w iv ab not given on time   Patient with preoperative order for iv antibiotic surgical si
   G8918          No Change       Pt w/o preop order iv ab pro   Patient without preoperative order for iv antibiotic surgical
   G8923          No Change       Lvef < 40% or lvsd             Left ventricular ejection fraction (lvef) < 40% or documentat
   G8924          No Change       Spir fev1/fvc<70%,fev<60%      Spirometry test results demonstrate fev1/fvc < 70%, fev < 60%
   G8925          No Change       Spir fev1/fvc>=60% & no copd   Spirometry test results demonstrate fev1 >= 60% fev1/fvc >= 7
   G8926          No Change       Spiro no perf or doc           Spirometry test not performed or documented, reason not given
   G8927          No Change       Adj chem pres ajcc iii         Adjuvant chemotherapy referred, prescribed or previously rece
   G8928          No Change       Adj chem not pres rsn spec     Adjuvant chemotherapy not prescribed or previously received,
   G8929          No Change       Adj cmo not pres rsn not gvn   Adjuvant chemotherapy not prescribed or previously received,
   G8930          No Change       Assess of dep @ initial eval   Assessment of depression severity at the initial evaluation
   G8931          No Change       Asses of dep not documented    Assessment of depression severity not documented, reason not
   G8932          No Change       Suicd rsk assessed init eval   Suicide risk assessed at the initial evaluation
   G8933          No Change       Suicide risk not assessed      Suicide risk not assessed at the initial evaluation, reason n
   G8934          No Change       Lvef <40% or dep lv sys fcn    Left ventricular ejection fraction (lvef) <40% or documentati
   G8935          No Change       Rx ace or arb therapy          Clinician prescribed angiotensin converting enzyme (ace) inhi
   G8936          No Change       Pt not eligible ace/arb        Clinician documented that patient was not an eligible candida
   G8937          No Change       No rx ace/arb therapy          Clinician did not prescribe angiotensin converting enzyme (ac
   G8938          No Change       Bmi doc onl fup nt doc         Bmi is documented as being outside of normal limits, follow-u
   G8939          No Change       Pain as doc positive, no f/u   Pain assessment documented as positive, follow-up plan not do
   G8940          No Change       Scr dep pos, no plan done      Screening for depression documented as positive, a follow-up
   G8941          No Change       Eld maltreatment doc as pos    Elder maltreatment screen documented as positive, follow-up p
   G8942          No Change       Doc fcn/care plan w/30 days    Functional outcomes assessment using a standardized tool is d
   G8943          No Change       Ldlc not pres w/i 12 mo prir   Ldl-c result not present or not within 12 months prior
   G8944          No Change       Ajcc mel cnr stg 0 - iic       Ajcc melanoma cancer stage 0 through iic melanoma
   G8946          No Change       Mibm but no dx of breast ca    Minimally invasive biopsy method attempted but not diagnostic
   G8947          No Change       1 or more neuropsych           One or more neuropsychiatric symptoms
   G8948          No Change       No neuropsych symptoms         No neuropsychiatric symptoms
   G8949          No Change       Doc pt reas on counsel diet    Documentation of patient reason(s) for patient not receiving
   G8950          No Change       Pre-htn or htn doc, f/u indc   Pre-hypertensive or hypertensive blood pressure reading docum
   G8951          No Change       Pre-htn/htn doc, no pt f/u     Pre-hypertensive or hypertensive blood pressure reading docum
   G8952          No Change       Pre-htn/htn, no f/u, not gvn   Pre-hypertensive or hypertensive blood pressure reading docum
   G8953          No Change       Oncology mg qual act perform   All quality actions for the applicable measures in the oncolo
   G8955          No Change       Most recent assess vol mgmt    Most recent assessment of adequacy of volume management docum
   G8956          No Change       Pt rcv hedia outpt dyls fac    Patient receiving maintenance hemodialysis in an outpatient d
   G8957          No Change       Pt no hedia in outpt fac       Patient not receiving maintenance hemodialysis in an outpatie
   G8958          No Change       Assess vol mgmt not doc        Assessment of adequacy of volume management not documented, r
   G8959          No Change       Clin tx mdd comm to tx clin    Clinician treating major depressive disorder communicates to
   G8960          No Change       Clin tx mdd not comm           Clinician treating major depressive disorder did not communic
   G8961          No Change       Csit lowrisk surg pts preop    Cardiac stress imaging test primarily performed on low-risk s
   G8962          No Change       Csit on pt any reas 30 days    Cardiac stress imaging test performed on patient for any reas
   G8963          No Change       Csi per asx pt w/pci 2 yrs     Cardiac stress imaging performed primarily for monitoring of
   G8964          No Change       Csi any other than pci 2 yr    Cardiac stress imaging test performed primarily for any other
   G8965          No Change       Csit perf on low chd rsk       Cardiac stress imaging test primarily performed on low chd ri
   G8966          No Change       Csit perf sx or high chd rsk   Cardiac stress imaging test performed on symptomatic or highe
   G8967          No Change       Warf or other fda drug presc   Warfarin or another fda approved oral anticoagulant is prescr
   G8968          No Change       Doc med not presb              Documentation of medical reason(s) for not prescribing warfar
   G8969          No Change       Doc pt rsn no presc warf/fda   Documentation of patient reason(s) for not prescribing warfar
   G8970          No Change       No rsk fac or 1 mod risk te    No risk factors or one moderate risk factor for thromboemboli
   G8971          No Change       Warfrn or othr antcog no rx    Warfarin or another oral anticoagulant that is fda approved n
   G8972          No Change       1>=risk or>= mod risk for te   One or more high risk factors for thromboembolism or more tha
   G8973          No Change       Mst rcnt hbb < 10g/dl          Most recent hemoglobin (hgb) level < 10 g/dl
   G8974          No Change       Hgb not doc rns not gvn        Hemoglobin level measurement not documented, reason not given
   G8975          No Change       Hgb <10g/dl, med rsn           Documentation of medical reason(s) for patient having a hemog
   G8976          No Change       Hgb >= 10 g/dl                 Most recent hemoglobin (hgb) level >= 10 g/dl
   G8977          No Change       Oncology measures grp          I intend to report the oncology measures group
   G8978          No Change       Mobility current status        Mobility: walking & moving around functional limitation, curr
   G8979          No Change       Mobility goal status           Mobility: walking & moving around functional limitation, proj
   G8980          No Change       Mobility d/c status            Mobility: walking & moving around functional limitation, disc
   G8981          No Change       Body pos current status        Changing & maintaining body position functional limitation, c
   G8982          No Change       Body pos goal status           Changing & maintaining body position functional limitation, p
   G8983          No Change       Body pos d/c status            Changing & maintaining body position functional limitation, d
   G8984          No Change       Carry current status           Carrying, moving & handling objects functional limitation, cu
   G8985          No Change       Carry goal status              Carrying, moving and handling objects, projected goal status,
   G8986          No Change       Carry d/c status               Carrying, moving & handling objects functional limitation, di
   G8987          No Change       Self care current status       Self care functional limitation, current status, at therapy e
   G8988          No Change       Self care goal status          Self care functional limitation, projected goal status, at th
   G8989          No Change       Self care d/c status           Self care functional limitation, discharge status, at dischar
   G8990          No Change       Other pt/ot current status     Other physical or occupational therapy primary functional lim
   G8991          No Change       Other pt/ot goal status        Other physical or occupational therapy primary functional lim
   G8992          No Change       Other pt/ot  d/c status        Other physical or occupational therapy primary functional lim
   G8993          No Change       Sub pt/ot current status       Other physical or occupational therapy subsequent functional
   G8994          No Change       Sub pt/ot goal status          Other physical or occupational therapy subsequent functional
   G8995          No Change       Sub pt/ot d/c status           Other physical or occupational therapy subsequent functional
   G8996          No Change       Swallow current status         Swallowing functional limitation, current status at therapy e
   G8997          No Change       Swallow goal status            Swallowing functional limitation, projected goal status, at t
   G8998          No Change       Swallow d/c status             Swallowing functional limitation, discharge status, at discha
   G8999          No Change       Motor speech current status    Motor speech functional limitation, current status at therapy
   G9001          No Change       Mccd, initial rate             Coordinated care fee, initial rate
   G9002          No Change       Mccd,maintenance rate          Coordinated care fee, maintenance rate
   G9003          No Change       Mccd, risk adj hi, initial     Coordinated care fee, risk adjusted high, initial
   G9004          No Change       Mccd, risk adj lo, initial     Coordinated care fee, risk adjusted low, initial
   G9005          No Change       Mccd, risk adj, maintenance    Coordinated care fee, risk adjusted maintenance
   G9006          No Change       Mccd, home monitoring          Coordinated care fee, home monitoring
   G9007          No Change       Mccd, sch team conf            Coordinated care fee, scheduled team conference
   G9008          No Change       Mccd,phys coor-care ovrsght    Coordinated care fee, physician coordinated care oversight se
   G9009          No Change       Mccd, risk adj, level 3        Coordinated care fee, risk adjusted maintenance, level 3
   G9010          No Change       Mccd, risk adj, level 4        Coordinated care fee, risk adjusted maintenance, level 4
   G9011          No Change       Mccd, risk adj, level 5        Coordinated care fee, risk adjusted maintenance, level 5
   G9012          No Change       Other specified case mgmt      Other specified case management service not elsewhere classif
   G9013          No Change       Esrd demo bundle level i       Esrd demo basic bundle level i
   G9014          No Change       Esrd demo bundle-level ii      Esrd demo expanded bundle including venous access and related
   G9016          No Change       Demo-smoking cessation coun    Smoking cessation counseling, individual, in the absence of o
   G9017          No Change       Amantadine hcl 100mg oral      Amantadine hydrochloride, oral, per 100 mg (for use in a medi
   G9018          No Change       Zanamivir,inhalation pwd 10m   Zanamivir, inhalation powder, administered through inhaler, p
   G9019          No Change       Oseltamivir phosphate 75mg     Oseltamivir phosphate, oral, per 75 mg (for use in a medicare
   G9020          No Change       Rimantadine hcl 100mg oral     Rimantadine hydrochloride, oral, per 100 mg (for use in a med
   G9033          No Change       Amantadine hcl oral brand      Amantadine hydrochloride, oral brand, per 100 mg (for use in
   G9034          No Change       Zanamivir, inh pwdr, brand     Zanamivir, inhalation powder, administered through inhaler, b
   G9035          No Change       Oseltamivir phosp, brand       Oseltamivir phosphate, oral, brand, per 75 mg (for use in a m
   G9036          No Change       Rimantadine hcl, brand         Rimantadine hydrochloride, oral, brand, per 100 mg (for use i
   G9050          No Change       Oncology work-up evaluation    Oncology; primary focus of visit; work-up, evaluation, or sta
   G9051          No Change       Oncology tx decision-mgmt      Oncology; primary focus of visit; treatment decision-making a
   G9052          No Change       Onc surveillance for disease   Oncology; primary focus of visit; surveillance for disease re
   G9053          No Change       Onc expectant management pt    Oncology; primary focus of visit; expectant management of pat
   G9054          No Change       Onc supervision palliative     Oncology; primary focus of visit; supervising, coordinating o
   G9055          No Change       Onc visit unspecified nos      Oncology; primary focus of visit; other, unspecified service
   G9056          No Change       Onc prac mgmt adheres guide    Oncology; practice guidelines; management adheres to guidelin
   G9057          No Change       Onc pract mgmt differs trial   Oncology; practice guidelines; management differs from guidel
   G9058          No Change       Onc prac mgmt disagree w/gui   Oncology; practice guidelines; management differs from guidel
   G9059          No Change       Onc prac mgmt pt opt alterna   Oncology; practice guidelines; management differs from guidel
   G9060          No Change       Onc prac mgmt dif pt comorb    Oncology; practice guidelines; management differs from guidel
   G9061          No Change       Onc prac cond noadd by guide   Oncology; practice guidelines; patient's condition not addres
   G9062          No Change       Onc prac guide differs nos     Oncology; practice guidelines; management differs from guidel
   G9063          No Change       Onc dx nsclc stgi no progres   Oncology; disease status; limited to non-small cell lung canc
   G9064          No Change       Onc dx nsclc stg2 no progres   Oncology; disease status; limited to non-small cell lung canc
   G9065          No Change       Onc dx nsclc stg3a no progre   Oncology; disease status; limited to non-small cell lung canc
   G9066          No Change       Onc dx nsclc stg3b-4 metasta   Oncology; disease status; limited to non-small cell lung canc
   G9067          No Change       Onc dx nsclc dx unknown nos    Oncology; disease status; limited to non-small cell lung canc
   G9068          No Change       Onc dx sclc/nsclc limited      Oncology; disease status; limited to small cell and combined
   G9069          No Change       Onc dx sclc/nsclc ext at dx    Oncology; disease status; small cell lung cancer, limited to
   G9070          No Change       Onc dx sclc/nsclc ext unknwn   Oncology; disease status; small cell lung cancer, limited to
   G9071          No Change       Onc dx brst stg1-2b hr,nopro   Oncology; disease status; invasive female breast cancer (does
   G9072          No Change       Onc dx brst stg1-2 noprogres   Oncology; disease status; invasive female breast cancer (does
   G9073          No Change       Onc dx brst stg3-hr, no pro    Oncology; disease status; invasive female breast cancer (does
   G9074          No Change       Onc dx brst stg3-noprogress    Oncology; disease status; invasive female breast cancer (does
   G9075          No Change       Onc dx brst metastic/ recur    Oncology; disease status; invasive female breast cancer (does
   G9077          No Change       Onc dx prostate t1no progres   Oncology; disease status; prostate cancer, limited to adenoca
   G9078          No Change       Onc dx prostate t2no progres   Oncology; disease status; prostate cancer, limited to adenoca
   G9079          No Change       Onc dx prostate t3b-t4noprog   Oncology; disease status; prostate cancer, limited to adenoca
   G9080          No Change       Onc dx prostate w/rise psa     Oncology; disease status; prostate cancer, limited to adenoca
   G9083          No Change       Onc dx prostate unknwn nos     Oncology; disease status; prostate cancer, limited to adenoca
   G9084          No Change       Onc dx colon t1-3,n1-2,no pr   Oncology; disease status; colon cancer, limited to invasive c
   G9085          No Change       Onc dx colon t4, n0 w/o prog   Oncology; disease status; colon cancer, limited to invasive c
   G9086          No Change       Onc dx colon t1-4 no dx prog   Oncology; disease status; colon cancer, limited to invasive c
   G9087          No Change       Onc dx colon metas evid dx     Oncology; disease status; colon cancer, limited to invasive c
   G9088          No Change       Onc dx colon metas noevid dx   Oncology; disease status; colon cancer, limited to invasive c
   G9089          No Change       Onc dx colon extent unknown    Oncology; disease status; colon cancer, limited to invasive c
   G9090          No Change       Onc dx rectal t1-2 no progr    Oncology; disease status; rectal cancer, limited to invasive
   G9091          No Change       Onc dx rectal t3 n0 no prog    Oncology; disease status; rectal cancer, limited to invasive
   G9092          No Change       Onc dx rectal t1-3,n1-2noprg   Oncology; disease status; rectal cancer, limited to invasive
   G9093          No Change       Onc dx rectal t4,n,m0 no prg   Oncology; disease status; rectal cancer, limited to invasive
   G9094          No Change       Onc dx rectal m1 w/mets prog   Oncology; disease status; rectal cancer, limited to invasive
   G9095          No Change       Onc dx rectal extent unknwn    Oncology; disease status; rectal cancer, limited to invasive
   G9096          No Change       Onc dx esophag t1-t3 noprog    Oncology; disease status; esophageal cancer, limited to adeno
   G9097          No Change       Onc dx esophageal t4 no prog   Oncology; disease status; esophageal cancer, limited to adeno
   G9098          No Change       Onc dx esophageal mets recur   Oncology; disease status; esophageal cancer, limited to adeno
   G9099          No Change       Onc dx esophageal unknown      Oncology; disease status; esophageal cancer, limited to adeno
   G9100          No Change       Onc dx gastric no recurrence   Oncology; disease status; gastric cancer, limited to adenocar
   G9101          No Change       Onc dx gastric p r1-r2noprog   Oncology; disease status; gastric cancer, limited to adenocar
   G9102          No Change       Onc dx gastric unresectable    Oncology; disease status; gastric cancer, limited to adenocar
   G9103          No Change       Onc dx gastric recurrent       Oncology; disease status; gastric cancer, limited to adenocar
   G9104          No Change       Onc dx gastric unknown nos     Oncology; disease status; gastric cancer, limited to adenocar
   G9105          No Change       Onc dx pancreatc p r0 res no   Oncology; disease status; pancreatic cancer, limited to adeno
   G9106          No Change       Onc dx pancreatc p r1/r2 no    Oncology; disease status; pancreatic cancer, limited to adeno
   G9107          No Change       Onc dx pancreatic unresectab   Oncology; disease status; pancreatic cancer, limited to adeno
   G9108          No Change       Onc dx pancreatic unknwn nos   Oncology; disease status; pancreatic cancer, limited to adeno
   G9109          No Change       Onc dx head/neck t1-t2no prg   Oncology; disease status; head and neck cancer, limited to ca
   G9110          No Change       Onc dx head/neck t3-4 noprog   Oncology; disease status; head and neck cancer, limited to ca
   G9111          No Change       Onc dx head/neck m1 mets rec   Oncology; disease status; head and neck cancer, limited to ca
   G9112          No Change       Onc dx head/neck ext unknown   Oncology; disease status; head and neck cancer, limited to ca
   G9113          No Change       Onc dx ovarian stg1a-b no pr   Oncology; disease status; ovarian cancer, limited to epitheli
   G9114          No Change       Onc dx ovarian stg1a-b or 2    Oncology; disease status; ovarian cancer, limited to epitheli
   G9115          No Change       Onc dx ovarian stg3/4 noprog   Oncology; disease status; ovarian cancer, limited to epitheli
   G9116          No Change       Onc dx ovarian recurrence      Oncology; disease status; ovarian cancer, limited to epitheli
   G9117          No Change       Onc dx ovarian unknown nos     Oncology; disease status; ovarian cancer, limited to epitheli
   G9123          No Change       Onc dx cml chronic phase       Oncology; disease status; chronic myelogenous leukemia, limit
   G9124          No Change       Onc dx cml acceler phase       Oncology; disease status; chronic myelogenous leukemia, limit
   G9125          No Change       Onc dx cml blast phase         Oncology; disease status; chronic myelogenous leukemia, limit
   G9126          No Change       Onc dx cml remission           Oncology; disease status; chronic myelogenous leukemia, limit
   G9128          No Change       Onc dx multi myeloma stage i   Oncology; disease status; limited to multiple myeloma, system
   G9129          No Change       Onc dx mult myeloma stg2 hig   Oncology; disease status; limited to multiple myeloma, system
   G9130          No Change       Onc dx multi myeloma unknown   Oncology; disease status; limited to multiple myeloma, system
   G9131          No Change       Onc dx brst unknown nos        Oncology; disease status; invasive female breast cancer (does
   G9132          No Change       Onc dx prostate mets no cast   Oncology; disease status; prostate cancer, limited to adenoca
   G9133          No Change       Onc dx prostate clinical met   Oncology; disease status; prostate cancer, limited to adenoca
   G9134          No Change       Onc nhlstg 1-2 no relap no     Oncology; disease status; non-hodgkin's lymphoma, any cellula
   G9135          No Change       Onc dx nhl stg 3-4 not relap   Oncology; disease status; non-hodgkin's lymphoma, any cellula
   G9136          No Change       Onc dx nhl trans to lg bcell   Oncology; disease status; non-hodgkin's lymphoma, transformed
   G9137          No Change       Onc dx nhl relapse/refractor   Oncology; disease status; non-hodgkin's lymphoma, any cellula
   G9138          No Change       Onc dx nhl stg unknown         Oncology; disease status; non-hodgkin's lymphoma, any cellula
   G9139          No Change       Onc dx cml dx status unknown   Oncology; disease status; chronic myelogenous leukemia, limit
   G9140          No Change       Frontier extended stay demo    Frontier extended stay clinic demonstration; for a patient st
   G9143          No Change       Warfarin respon genetic test   Warfarin responsiveness testing by genetic technique using an
   G9147          No Change       Outpt iv insulin tx any mea    Outpatient intravenous insulin treatment (oivit) either pulsa
   G9148          No Change       Medical home level 1           National committee for quality assurance - level 1 medical ho
   G9149          No Change       Medical home level ii          National committee for quality assurance - level 2 medical ho
   G9150          No Change       Medical home level iii         National committee for quality assurance - level 3 medical ho
   G9151          No Change       Mapcp demo state               Mapcp demonstration - state provided services
   G9152          No Change       Mapcp demo community           Mapcp demonstration - community health teams
   G9153          No Change       Mapcp demo physician           Mapcp demonstration - physician incentive pool
   G9156          No Change       Evaluation for wheelchair      Evaluation for wheelchair requiring face to face visit with p
   G9157          No Change       Transesoph doppl cardiac mon   Transesophageal doppler measurement of cardiac output (includ
   G9158          No Change       Motor speech d/c status        Motor speech functional limitation, discharge status, at disc
   G9159          No Change       Lang comp current status       Spoken language comprehension functional limitation, current
   G9160          No Change       Lang comp goal status          Spoken language comprehension functional limitation, projecte
   G9161          No Change       Lang comp d/c status           Spoken language comprehension functional limitation, discharg
   G9162          No Change       Lang express current status    Spoken language expression functional limitation, current sta
   G9163          No Change       Lang express goal status       Spoken language expression functional limitation, projected g
   G9164          No Change       Lang express d/c status        Spoken language expression functional limitation, discharge s
   G9165          No Change       Atten current status           Attention functional limitation, current status at therapy ep
   G9166          No Change       Atten goal status              Attention functional limitation, projected goal status at the
   G9167          No Change       Atten d/c status               Attention functional limitation, discharge status at discharg
   G9168          No Change       Memory current status          Memory functional limitation, current status at therapy episo
   G9169          No Change       Memory goal status             Memory functional limitation, projected goal status at therap
   G9170          No Change       Memory d/c status              Memory functional limitation, discharge status at discharge f
   G9171          No Change       Voice current status           Voice functional limitation, current status at therapy episod
   G9172          No Change       Voice goal status              Voice functional limitation, projected goal status at therapy
   G9173          No Change       Voice d/c status               Voice functional limitation, discharge status at discharge fr
   G9174          No Change       Speech lang current status     Other speech language pathology functional limitation, curren
   G9175          No Change       Speech lang goal status        Other speech language pathology functional limitation, projec
   G9176          No Change       Speech lang d/c status         Other speech language pathology functional limitation, discha
   G9186          No Change       Motor speech goal status       Motor speech functional limitation, projected goal status at
   G9187          No Change       Bpci home visit                Bundled payments for care improvement initiative home visit f
   G9188          No Change       Beta not given no reason       Beta-blocker therapy not prescribed, reason not given
   G9189          No Change       Beta pres or already taking    Beta-blocker therapy prescribed or currently being taken
   G9190          No Change       Medical reason for no beta     Documentation of medical reason(s) for not prescribing beta-b
   G9191          No Change       Pt reason for no beta          Documentation of patient reason(s) for not prescribing beta-b
   G9192          No Change       System reason for no beta      Documentation of system reason(s) for not prescribing beta-bl
   G9193          No Change       Doc not eligible for dep med   Clinician documented that patient with a diagnosis of major d
   G9194          No Change       Mdd pt treated for 180d        Patient with a diagnosis of major depression documented as be
   G9195          No Change       Mdd pt not treated for 180d    Patient with a diagnosis of major depression not documented a
   G9196          No Change       Med reason for no ceph         Documentation of medical reason(s) for not ordering a first o
   G9197          No Change       Order for ceph                 Documentation of order for first or second generation cephalo
   G9198          No Change       No order for ceph no reason    Order for first or second generation cephalosporin for antimi
   G9199          No Change       Doc reason for no vte          Venous thromboembolism (vte) prophylaxis not administered the
   G9200          No Change       No reason for no vte           Venous thromboembolism (vte) prophylaxis was not administered
   G9201          No Change       Vte given upon admission       Venous thromboembolism (vte) prophylaxis administered the day
   G9202          No Change       Hep c aby pos                  Patients with a positive hepatitis c antibody test
   G9203          No Change       Hep c rna done prior to med    Rna testing for hepatitis c documented as performed within 12
   G9204          No Change       No reason for no hep c rna     Rna testing for hepatitis c was not documented as performed w
   G9205          No Change       Hep c antiviral started        Patient starting antiviral treatmentfor hepatitis c during th
   G9206          No Change       Hep c therapy started          Patient starting antiviral treatment for hepatitis c during t
   G9207          No Change       Hep c genotype prior to med    Hepatitis c genotype testing documented as performed within 1
   G9208          No Change       No reason for no hep c geno    Hepatitis c genotype testing was not documented as performed
   G9209          No Change       Hep c rna 4to12 wk after med   Hepatitis c quantitative rna testing documented as performed
   G9210          No Change       No hepc rna after med docrsn   Hepatitis c quantitative rna testing not performed between 4-
   G9211          No Change       No hepc rna after med no rsn   Hepatitis c quantitative rna testing was not documented as pe
   G9212          No Change       Doc of dsm-iv init eval        Dsm-ivtm criteria for major depressive disorder documented at
   G9213          No Change       No doc of dsm-iv               Dsm-iv-tr criteria for major depressive disorder not document
   G9214          No Change       Cd4 count documented           Cd4+ cell count or cd4+ cell percentage results documented
   G9215          No Change       No cd4 count no reason         Cd4+ cell count or percentage not documented as performed, re
   G9216          No Change       No pcp proph at dx no reason   Pcp prophylaxis was not prescribed at time of diagnosis of hi
   G9217          No Change       No pcp proph low cd4 norsn     Pcp prophylaxis was not prescribed within 3 months of low cd4
   G9218          No Change       No pcp prop low at cd4 norsn   Pcp prophylaxis was not prescribed within 3 months oflow cd4+
   G9219          No Change       No oder pjp for med reason     Pneumocystis jiroveci pneumonia prophylaxis not prescribed wi
   G9220          No Change       No order for pjp for medrsn    Pneumocystis jiroveci pneumonia prophylaxis not prescribed wi
   G9221          No Change       Pjp proph prescribed           Pneumocystis jiroveci pneumonia prophlaxis prescribed
   G9222          No Change       Pjp proph ordered low cd4      Pneumocystis jiroveci pneumonia prophylaxis prescribed wthin
   G9223          No Change       Pjp proph ordered cd4 low      Pneumocystis jiroveci pneumonia prophylaxis prescribed within
   G9224          No Change       Medrsn no foot exam            Documentation of medical reason for not performing foot exam
   G9225          No Change       Norsn no foot exam             Foot exam was not performed, reason not given
   G9226          No Change       3 comp foot exam completed     Foot examination performed (includes examination through visu
   G9227          No Change       Foa doc, care plan not doc     Functional outcome assessment documented, care plan not docum
   G9228          No Change       Gc chl syp documented          Chlamydia, gonorrhea and syphilis screening results documente
   G9229          No Change       Ptrsn no gc chl syp test       Chlamydia, gonorrhea, and syphilis screening results not docu
   G9230          No Change       Norsn for gc chl syp test      Chlamydia, gonorrhea, and syphilis not screened, reason not g
   G9231          No Change       Doc esrd dia trans preg        Documentation of end stage renal disease (esrd), dialysis, re
   G9232          No Change       Ptrsn no comm comorbid         Clinician treating major depressive disorder did not communic
   G9233          No Change       Tkr composite                  All quality actions for the applicable measures in the total
   G9234          No Change       Tkr intent                     I intend to report the total knee replacement measures group
   G9235          No Change       Gs mg composite                All quality actions for the applicable measures in the genera
   G9236          No Change       Op rad mg composite            All quality actions for the applicable measures in the optimi
   G9237          No Change       Gs mg intent                   I intend to report the general surgery measures group
   G9238          No Change       Op rad mg intent               I intend to report the optimizing patient exposure to ionizin
   G9239          No Change       Doc rsn hemod & cath acc       Documentation of reasons for patient initiaiting maintenance
   G9240          No Change       Doc pt w cath maint dia        Patient whose mode of vascular access is a catheter at the ti
   G9241          No Change       Doc pt w out cath maint dia    Patient whose mode of vascular access is not a catheter at th
   G9242          No Change       Doc viral load >=200           Documentation of viral load equal to or greater than 200 copi
   G9243          No Change       Doc viral load <200            Documentation of viral load less than 200 copies/ml
   G9244          No Change       Antiviral not ordered          Antiretroviral thereapy not prescribed
   G9245          No Change       Antiviral ordered              Antiretroviral therapy prescribed
   G9246          No Change       No med visit in 24mo           Patient did not have at least one medical visit in each 6 mon
   G9247          No Change       1 med visit in 24mo            Patient had at least one medical visit in each 6 month period
   G9248          No Change       No med visit 6mo               Patient did not have a medical visit in the last 6 months
   G9249          No Change       Med visit w in 6mo             Patient had a medical visit in the last 6 months
   G9250          No Change       Doc of pain comfort 48hr       Documentation of patient pain brought to a comfortable level
   G9251          No Change       Doc no pain comfort 48hr       Documentation of patient with pain not brought to a comfortab
   G9252          No Change       Neo detect scrn colo           Adenoma(s) or other neoplasm detected during screening colono
   G9253          No Change       No neo detect scrn colo        Adenoma(s) or other neoplasm not detected during screening co
   G9254          No Change       Doc pt dischg >2d              Documentation of patient discharged to home later than post-o
   G9255          No Change       Doc pt dischg <=2d             Documentation of patient discharged to home no later than pos
   G9256          No Change       Doc of pat death after cas     Documentation of patient death following cas
   G9257          No Change       Doc of pat stroke after cas    Documentation of patient stroke following cas
   G9258          No Change       Doc of pat stroke after cea    Documentation of patient stroke following cea
   G9259          No Change       Survive/no stroke post cas     Documentation of patient survival and absence of stroke follo
   G9260          No Change       Doc of pat death after cea     Documentation of patient death following cea
   G9261          No Change       Survive/no stroke post cea     Documentation of patient survival and absence of stroke follo
   G9262          No Change       Doc of death post-aaa repair   Documentation of patient death in the hospital following endo
   G9263          No Change       Doc of disch post-aaa repair   Documentation of patient discharged alive following endovascu
   G9264          No Change       Doc rsn hemod w/cath >=90d     Documentation of patient receiving maintenance hemodialysis f
   G9265          No Change       Doc cath >90d for maint dia    Patient receiving maintenance hemodialysis for greater than o
   G9266          No Change       Norsn pt cath >=90d            Patient receiving maintenance hemodialysis for greater than o
   G9267          No Change       Doc comp or mort w in 30d      Documentation of patient with one or more complications or mo
   G9268          No Change       Doc comp or mort w in 90d      Documentation of patient with one or more complications withi
   G9269          No Change       Doc no comp or mort w in 30d   Documentation of patient without one or more complications an
   G9270          No Change       Doc no comp or mort w in 90d   Documentation of patient without one or more complications wi
   G9271          No Change       Ldl under 100                  Ldl value < 100
   G9272          No Change       Ldl 100 and over               Ldl value >= 100
   G9273          No Change       Sys<140 and dia<90             Blood pressure has a systolic value of < 140 and a diastolic
   G9274          No Change       Bp out of nrml limits          Blood pressure has a systolic value of =140 and a diastolic v
   G9275          No Change       Doc of non tobacco user        Documentation that patient is a current non-tobacco user
   G9276          No Change       Doc of tobacco user            Documentation that patient is a current tobacco user
   G9277          No Change       Doc daily aspirin or contra    Documentation that the patient is on daily aspirin or anti-pl
   G9278          No Change       Doc no daily aspirin           Documentation that the patient is not on daily aspirin or ant
   G9279          No Change       Pne scrn done doc vac done     Pneumococcal screening performed and documentation of vaccina
   G9280          No Change       Pne not given norsn            Pneumococcal vaccination not administered prior to discharge,
   G9281          No Change       Pne scrn done doc not ind      Screening performed and documentation that vaccination not in
   G9282          No Change       Doc medrsn no histo type       Documentation of medical reason(s) for not reporting the hist
   G9283          No Change       Hist type doc on report        Non small cell lung cancer biopsy and cytology specimen repor
   G9284          No Change       No hist type doc on report     Non small cell lung cancer biopsy and cytology specimen repor
   G9285          No Change       Site not small cell lung ca    Specimen site other than anatomic location of lung or is not
   G9286          No Change       Antibio rx w in 10d of sympt   Antibiotic regimen prescribed within 10 days after onset of s
   G9287          No Change       No antibio w in 10d of sympt   Antibiotic regimen not prescribed within 10 days after onset
   G9288          No Change       Doc medrsn no hist type rpt    Documentation of medical reason(s) for not reporting the hist
   G9289          No Change       Doc type nsm lung ca           Non small cell lung cancer biopsy and cytology specimen repor
   G9290          No Change       No doc type nsm lung ca        Non small cell lung cancer biopsy and cytology specimen repor
   G9291          No Change       Not nsm lung ca                Specimen site other than anatomic location of lung, is not cl
   G9292          No Change       Medrsn no pt category          Documentation of medical reason(s) for not reporting pt categ
   G9293          No Change       No pt category on report       Pathology report does not include the pt category and a state
   G9294          No Change       Pt cat and thck on report      Pathology report includes the pt category and a statement on
   G9295          No Change       Non cutaneous loc              Specimen site other than anatomic cutaneous location
   G9296          No Change       Doc share dec prior proc       Patients with documented shared decision-making including dis
   G9297          No Change       No doc share dec prior proc    Shared decision-making including discussion of conservative (
   G9298          No Change       Eval risk vte card 30d prior   Patients who are evaluated for venous thromboembolic and card
   G9299          No Change       No eval riskk vte card prior   Patients who are not evaluated for venous thromboembolic and
   G9300          No Change       Doc medrsn no compl antibio    Documentation of medical reason(s) for not completely infusin
   G9301          No Change       Doc compl inf antibio          Patients who had the prophylactic antibiotic completely infus
   G9302          No Change       Norsn incomp inf antibio       Prophylactic antibiotic not completely infused prior to the i
   G9303          No Change       Norsn no pros info op rpt      Operative report does not identify the prosthetic implant spe
   G9304          No Change       Pros info op rpt               Operative report identifies the prosthetic implant specificat
   G9305          No Change       No interv req for leak         Intervention for presence of leak of endoluminal contents thr
   G9306          No Change       Interv req for leak            Intervention for presence of leak of endoluminal contents thr
   G9307          No Change       No ret for surg w in 30d       No return to the operating room for a surgical procedure, for
   G9308          No Change       Unpl ret or w/compl w/in 30d   Unplanned return to the operating room for a surgical procedu
   G9309          No Change       No unplnd hosp readm in 30d    No unplanned hospital readmission within 30 days of principal
   G9310          No Change       Unplnd hosp readm in 30d       Unplanned hospital readmission within 30 days of principal pr
   G9311          No Change       No surg site infection         No surgical site infection
   G9312          No Change       Surgical site infection        Surgical site infection
   G9313          No Change       Amoxic not presc as 1st line   Amoxicillin, with or without clavulanate, not prescribed as f
   G9314          No Change       Norsn not first line amox      Amoxicillin, with or without clavulanate, not prescribed as f
   G9315          No Change       Doc first line amox            Documentation amoxicillin, with or without clavulanate, presc
   G9316          No Change       Doc comm risk calc             Documentation of patient-specific risk assessment with a risk
   G9317          No Change       No doc comm risk calc          Documentation of patient-specific risk assessment with a risk
   G9318          No Change       Image std nomenclature         Imaging study named according to standardized nomenclature
   G9319          No Change       Image not std nomenclature     Imaging study not named according to standardized nomenclatur
   G9320          No Change       Medrsn no std nomenclature     Documentation of medical reason(s) for not naming ct studies
   G9321          No Change       Doc count of ct in 12mo        Count of previous ct (any type of ct) and cardiac nuclear med
   G9322          No Change       No doc count of ct in 12mo     Count of previous ct and cardiac nuclear medicine (myocardial
   G9323          No Change       Mdrsn no doc cnt of ct         Documentation of medical reason(s) for not counting previous
   G9324          No Change       Not all data norsn             All necessary data elements not included, reason not given
   G9325          No Change       Medrsn no ct rpt to reg        Ct studies not reported to a radiation dose index registry du
   G9326          No Change       Ct done no rad ds index, nrg   Ct studies performed not reported to a radiation dose index r
   G9327          No Change       Ct done rad ds index           Ct studies performed reported to a radiation dose index regis
   G9328          No Change       Medrsn no dicom format doc     Dicom format image data availability not documented in final
   G9329          No Change       Norsn no dicom format doc      Dicom format image data available to non-affiliated external
   G9340          No Change       Dicom format doc on rpt        Final report documented that dicom format image data availabl
   G9341          No Change       Srch for ct w in 12 mos        Search conducted for prior patient ct studies completed at no
   G9342          No Change       No srch for ct in 12mo norsn   Search not conducted prior to an imaging study being performe
   G9343          No Change       Medrsn no dicom srch           Due to medical reasons, search not conducted for dicom format
   G9344          No Change       Sysrsn no dicom srch           Due to system reasons search not conducted for dicom format i
   G9345          No Change       Follow up pulm nod             Follow-up recommendations documented according to recommended
   G9346          No Change       No follow up pulm nod          Follow-up recommendations not documented according to recomme
   G9347          No Change       No follow up pulm nod norsn    Follow-up recommendations not documented according to recomme
   G9348          No Change       Doc rsn for ord ct scan        Ct scan of the paranasal sinuses ordered at the time of diagn
   G9349          No Change       Doc sinus ct 28d               Documentation of a ct scan of the paranasal sinuses ordered a
   G9350          No Change       No doc sinus ct 28d or dx      Ct scan of the paranasal sinuses not ordered at the time of d
   G9351          No Change       Doc >1 sinus ct w 90d dx       More than one ct scan of the paranasal sinuses ordered or rec
   G9352          No Change       Not >1 sinus ct w 90d dx       More than one ct scan of the paranasal sinuses ordered or rec
   G9353          No Change       Medrsn >1 sinus ct w 90d dx    More than one ct scan of the paranasal sinuses ordered or rec
   G9354          No Change       1 or no ct sinus w/in 90d dx   One ct scan or no ct scan of the paranasal sinuses ordered wi
   G9355          No Change       No early ind/delivery          Elective delivery or early induction not performed
   G9356          No Change       Early ind/delivery             Elective delivery or early induction performed
   G9357          No Change       Pp eval/edu perf               Post-partum screenings, evaluations and education performed
   G9358          No Change       Pp eval/edu not perf           Post-partum screenings, evaluations and education not perform
   G9359          No Change       Doc of neg or man pos tb scn   Documentation of negative or managed positive tb screen with
   G9360          No Change       No doc of neg or man pos tb    No documentation of negative or managed positive tb screen
   G9361          No Change       Doc rsn elect c-sec/induct     Medical indication for induction [documentation of reason(s)
   G9362          No Change       Mac or pnb w/o genanes >60m    Duration of monitored anesthesia care (mac) or peripheral ner
   G9363          No Change       Mac or pnb w/o genanes <60m    Duration of monitored anesthesia care (mac) or peripheral ner
   G9364          No Change       Sinus caus bac inx             Sinusitis caused by, or presumed to be caused by, bacterial i
   G9365          No Change       1high risk med ord             One high-risk medication ordered
   G9366          No Change       1high risk no ord              One high-risk medication not ordered
   G9367          No Change       >= 2 same hi-rsk med ord       At least two orders for the same high-risk medication
   G9368          No Change       >= 2 same hi-rsk med not ord   At least two orders for the same high-risk medications not or
   G9369          No Change       Fill 2 rx antipsych            Individual filled at least two prescriptions for any antipsyc
   G9370          No Change       Not fill 2 rx antipsych        Individual who did not fill at least two prescriptions for an
   G9376          No Change       Contd ret attach at 6mth f/u   Patient continued to have the retina attached at the 6 months
   G9377          No Change       No ret attach after 6mt        Patient did not have the retina attached after 6 months follo
   G9378          No Change       Contd ret attach f/u vis       Patient continued to have the retina attached at the 6 months
   G9379          No Change       No acheive flat ret 6mth       Patient did not achieve flat retinas six months post surgery
   G9380          No Change       Off assis eol iss              Patient offered assistance with end of life issues during the
   G9381          No Change       Doc med reas no offer eol      Documentation of medical reason(s) for not offering assistanc
   G9382          No Change       No off assis eol               Patient not offered assistance with end of life issues during
   G9383          No Change       Recd scrn hcv infec            Patient received screening for hcv infection within the 12 mo
   G9384          No Change       Doc med rsn no hcv scrn        Documentation of medical reason(s) for not receiving annual s
   G9385          No Change       Doc pt reas not rec hcv srn    Documentation of patient reason(s) for not receiving annual s
   G9386          No Change       Scrn hcv infec not recd        Screening for hcv infection not received within the 12 month
   G9389          No Change       Unpln rup post cap             Unplanned rupture of the posterior capsule requiring vitrecto
   G9390          No Change       No unpln rup post cap          No unplanned rupture of the posterior capsule requiring vitre
   G9391          No Change       Achv refrac +1d                Patient achieves refraction +-1 d for the eye that underwent
   G9392          No Change       Not achv refrac +1d            Patient does not achieve refraction +-1 d for the eye that un
   G9393          No Change       Ini phq9 >9 remiss <5          Patient with an initial phq-9 score greater than nine who ach
   G9394          No Change       Dx bipol, death, nhres, hosp   Patient who had a diagnosis of bipolar disorder or personalit
   G9395          No Change       Ini phq9 >9 no remiss >=5      Patient with an initial phq-9 score greater than nine who did
   G9396          No Change       Ini phq9 >9 not assess         Patient with an initial phq-9 score greater than nine who was
   G9399          No Change       Doc disc tx choices            Documentation in the patient record of a discussion between t
   G9400          No Change       Doc reas no disc tx opt        Documentation of medical or patient reason(s) for not discuss
   G9401          No Change       No disc tx choices             No documentation of a discussion in the patient record of a d
   G9402          No Change       Recd f/u w/in 30d disch        Patient received follow-up on the date of discharge or within
   G9403          No Change       Doc reas no 30 day f/u         Clinician documented reason patient was not able to complete
   G9404          No Change       No 30 day f/u                  Patient did not receive follow-up on the date of discharge or
   G9405          No Change       Recd f/u w/in 7d disch         Patient received follow-up within 7 days from discharge
   G9406          No Change       Doc reas no 7d f/u             Clinician documented reason patient was not able to complete
   G9407          No Change       No 7d f/u                      Patient did not receive follow-up on or within 7 days after d
   G9408          No Change       Card tamp w/in 30d             Patients with cardiac tamponade and/or pericardiocentesis occ
   G9409          No Change       No card tamp e/in 30d          Patients without cardiac tamponade and/or pericardiocentesis
   G9410          No Change       Admit w/in 180d req remov      Patient admitted within 180 days, status post cied implantati
   G9411          No Change       No admit w/in 180d req remov   Patient not admitted within 180 days, status post cied implan
   G9412          No Change       Admit w/in 180d req surg rev   Patient admitted within 180 days, status post cied implantati
   G9413          No Change       No admit req surg rev          Patient not admitted within 180 days, status post cied implan
   G9414          No Change       1dose menig vac btwn 11 & 13   Patient had one dose of meningococcal vaccine on or between t
   G9415          No Change       No 1dose meni vac btwn 11&13   Patient did not have one dose of meningococcal vaccine on or
   G9416          No Change       Pt 1 tdap betw 10-13 yrs       Patient had one tetanus, diphtheria toxoids and acellular per
   G9417          No Change       Pt not 1 tdap betw 10-13 yrs   Patient did not have one tetanus, diphtheria toxoids and acel
   G9418          No Change       Lungcx bx rpt docs class       Primary non-small cell lung cancer biopsy and cytology specim
   G9419          No Change       Med reas not incl histo type   Documentation of medical reason(s) for not including the hist
   G9420          No Change       Spec site no lung              Specimen site other than anatomic location of lung or is not
   G9421          No Change       Lung cx bx rpt no doc class    Primary non-small cell lung cancer biopsy and cytology specim
   G9422          No Change       Rpt doc class histo type       Primary lung carcinoma resection report documents pt category
   G9423          No Change       Med reas rpt no histo type     Documentation of medical reason for not including pt category
   G9424          No Change       Site no lung or lung cx        Specimen site other than anatomic location of lung, or classi
   G9425          No Change       Spec rpt no doc class histo    Primary lung carcinoma resection report does not document pt
   G9426          No Change       Impr med time edarr pain med   Improvement in median time from ed arrival to initial ed oral
   G9427          No Change       No impro med time pain med     Improvement in median time from ed arrival to initial ed oral
   G9430          No Change       Spec site no cutaneous         Specimen site other than anatomic cutaneous location
   G9432          No Change       Asth controlled                Asthma well-controlled based on the act, c-act, acq, or ataq
   G9433          No Change       Death, nhres, hospice          Death, permanent nursing home resident or receiving hospice o
   G9434          No Change       Asth not controlled            Asthma not well-controlled based on the act, c-act, acq, or a
   G9435          No Change       Asp presc disch                Aspirin prescribed at discharge
   G9436          No Change       Asp not presc doc reas         Aspirin not prescribed for documented reasons (e.g., allergy,
   G9437          No Change       Asp not presc disch            Aspirin not prescribed at discharge
   G9438          No Change       P2y inhib presc                P2y inhibitor prescribed at discharge
   G9439          No Change       P2y inhib not presc doc reas   P2y inhibitor not prescribed for documented reasons (e.g., al
   G9440          No Change       P2y inhib not presc            P2y inhibitor not prescribed at discharge
   G9441          No Change       Statin presc disch             Statin prescribed at discharge
   G9442          No Change       Statin not presc doc reas      Statin not prescribed for documented reasons (e.g., allergy,
   G9443          No Change       Statin not presc disch         Statin not prescribed at discharge
   G9448          No Change       Born 1945-1965                 Patients who were born in the years 1945?1965
   G9449          No Change       Hx bld transf b/f 1992         History of receiving blood transfusions prior to 1992
   G9450          No Change       Hx injec drug use              History of injection drug use
   G9451          No Change       1x scrn hcv infect             Patient received one-time screening for hcv infection
   G9452          No Change       Doc med reas no scrn hcv       Documentation of medical reason(s) for not receiving one-time
   G9453          No Change       Pt reas no hcv infect          Documentation of patient reason(s) for not receiving one-time
   G9455          No Change       Abd imag w/us, ct or mri       Patient underwent abdominal imaging with ultrasound, contrast
   G9456          No Change       Doc med pt reas no hcc scrn    Documentation of medical or patient reason(s) for not orderin
   G9458          No Change       Tob user recd cess interv      Patient documented as tobacco user and received tobacco cessa
   G9459          No Change       Tob non-user                   Currently a tobacco non-user
   G9460          No Change       No tob assess or cess inter    Tobacco assessment or tobacco cessation intervention not perf
   G9463          No Change       Sinusitis intent               I intend to report the sinusitis measures group
   G9464          No Change       Sinusitis comp                 All quality actions for the applicable measures in the sinusi
   G9465          No Change       Aoe intent                     I intend to report the acute otitis externa (aoe) measures gr
   G9466          No Change       Aoe comp                       All quality actions for the applicable measures in the aoe me
   G9467          No Change       Recd cortico >=10mg/day >60d   Patient who have received or are receiving corticosteroids gr
   G9468          No Change       No recd cortico>=10mg/d >60d   Patient not receiving corticosteroids greater than or equal t
   G9469          No Change       Rec cortico>60d or 1rx 600mg   Patients who have received or are receiving corticosteroids g
   G9470          No Change       No rec cortico>60d 1rx 600mg   Patients not receiving corticosteroids greater than or equal
   G9471          No Change       W/in 2yr dxa not order         Within the past 2 years, central dual-energy x-ray absorptiom
   G9472          No Change       No dxa no med hx no rv sx      Within the past 2 years, central dual-energy x-ray absorptiom
   G9473          No Change       Chap services at hospice       Services performed by chaplain in the hospice setting, each 1
   G9474          No Change       Diet counsel at hospice        Services performed by dietary counselor in the hospice settin
   G9475          No Change       Other counselor at hospice     Services performed by other counselor in the hospice setting,
   G9476          No Change       Volun service at hospice       Services performed by volunteer in the hospice setting, each
   G9477          No Change       Care coord at hospice          Services performed by care coordinator in the hospice setting
   G9478          No Change       Othe therapist at hospice      Services performed by other qualified therapist in the hospic
   G9479          No Change       Pharmacist at hospice          Services performed by qualified pharmacist in the hospice set
   G9480          No Change       Admission to mccm              Admission to medicare care choice model program (mccm)
   G9481          No Change       Remote e/m new pt 10mins       Remote in-home visit for the evaluation and management of a n
   G9482          No Change       Remote e/m new pt 20mins       Remote in-home visit for the evaluation and management of a n
   G9483          No Change       Remote e/m new pt 30mins       Remote in-home visit for the evaluation and management of a n
   G9484          No Change       Remote e/m new pt 45mins       Remote in-home visit for the evaluation and management of a n
   G9485          No Change       Remote e/m new pt 60mins       Remote in-home visit for the evaluation and management of a n
   G9486          No Change       Remote e/m est. pt 10mins      Remote in-home visit for the evaluation and management of an
   G9487          No Change       Remote e/m est. pt 15mins      Remote in-home visit for the evaluation and management of an
   G9488          No Change       Remote e/m est. pt 25mins      Remote in-home visit for the evaluation and management of an
   G9489          No Change       Remote e/m est. pt 40mins      Remote in-home visit for the evaluation and management of an
   G9490          No Change       Cmmi mod home visit            Cms innovation center models, home visit for patient assessme
   G9496          No Change       Doc rsn no adeno/neopl detec   Documentation of reason for not detecting adenoma(s) or other
   G9497          No Change       Rec inst no smoke day surg     Received instruction from the anesthesiologist or proxy prior
   G9498          No Change       Abx reg prescribed             Antibiotic regimen prescribed
   G9499          No Change       No start/rec antvir tx hep c   Patient did not start or is not receiving antiviral treatment
   G9500          No Change       Rad expos ind/exp tm doc       Radiation exposure indices, or exposure time and number of fl
   G9501          No Change       Rad expos ind/exp tm no doc    Radiation exposure indices, or exposure time and number of fl
   G9502          No Change       Med reas no perf foot exam     Documentation of medical reason for not performing foot exam
   G9503          No Change       Pt tk tams hcl                 Patient taking tamsulosin hydrochloride
   G9504          No Change       Doc rsn hep b stat not asses   Documented reason for not assessing hepatitis b virus (hbv) s
   G9505          No Change       Abx pres w/in 10 dys of symp   Antibiotic regimen prescribed within 10 days after onset of s
   G9506          No Change       Bio imm resp mod presc         Biologic immune response modifier prescribed
   G9507          No Change       Doc reas on statin or contra   Documentation that the patient is on a statin medication or h
   G9508          No Change       Doc pt not on statin           Documentation that the patient is not on a statin medication
   G9510          No Change       Remis 12m not phq-9 score <5   Remission at twelve months not demonstrated by a twelve month
   G9512          No Change       Indiv pdc > 0.8                Individual had a pdc of 0.8 or greater
   G9513          No Change       Indiv pdc not > 0.8            Individual did not have a pdc of 0.8 or greater
   G9514          No Change       Req ret or w/in 90d of surg    Patient required a return to the operating room within 90 day
   G9515          No Change       No reas, no ret or w/in 90d    Patient did not require a return to the operating room within
   G9516          No Change       Impr vis acuit w/in 90d        Patient achieved an improvement in visual acuity, from their
   G9517          No Change       No impr vis acuit w/in 90d     Patient did not achieve an improvement in visual acuity, from
   G9518          No Change       Doc active inj drug use        Documentation of active injection drug use
   G9519          No Change       Final ref +/- 0.5 w/in 90d     Patient achieves final refraction (spherical equivalent) +/-
   G9520          No Change       Refract not +/- 0.5 w/in 90d   Patient does not achieve final refraction (spherical equivale
   G9521          No Change       Er and ip hosp <2 in 12 mos    Total number of emergency department visits and inpatient hos
   G9522          No Change       Er/ip hosp =/>2 in 12 mos      Total number of emergency department visits and inpatient hos
   G9523          No Change       D/c hemo or perit dialysis     Patient discontinued from hemodialysis or peritoneal dialysis
   G9524          No Change       Refer to hospice               Patient was referred to hospice care
   G9525          No Change       Doc pt reas no hospice refer   Documentation of patient reason(s) for not referring to hospi
   G9526          No Change       No reason, no refer hospice    Patient was not referred to hospice care, reason not given
   G9529          No Change       Minor blunt trauma w/head ct   Patient with minor blunt head trauma had an appropriate indic
   G9533          No Change       Indic for head ct not valid    Patient with minor blunt head trauma did not have an appropri
   G9539          No Change       Intent pot remv time placemt   Intent for potential removal at time of placement
   G9540          No Change       Pt alive 3 mos post proc       Patient alive 3 months post procedure
   G9541          No Change       Filter rem 3 mon plmt          Filter removed within 3 months of placement
   G9542          No Change       Doc reass appr remo filt 3ms   Documented re-assessment for the appropriateness of filter re
   G9543          No Change       Doc 2x re-assess filt remov    Documentation of at least two attempts to reach the patient t
   G9544          No Change       No filt remov w/in 3mos plcm   Patients that do not have the filter removed, documented re-a
   G9547          No Change       Incid finding liver/kid/adre   Incidental finding: liver lesion <= 0.5 cm, cystic kidney les
   G9548          No Change       Abd imag and followup rec      Final reports for abdominal imaging studies with follow-up im
   G9549          No Change       Doc med rsn for follow imag    Documentation of medical reason(s) that follow-up imaging is
   G9550          No Change       Abd imag and followup no rec   Final reports for abdominal imaging studies with follow-up im
   G9551          No Change       Abd imag no les,kid/livr/adr   Final reports for abdominal imaging studies without an incide
   G9552          No Change       Inc thyr node <1.0 in rpt      Incidental thyroid nodule < 1.0 cm noted in report
   G9553          No Change       Prior thyroid dise dx          Prior thyroid disease diagnosis
   G9554          No Change       Ct/cta/mri/a chst foll rec     Final reports for ct, cta, mri or mra of the chest or neck or
   G9555          No Change       Doc med rsn for follup image   Documentation of medical reason(s) for recommending follow up
   G9556          No Change       Ct/cta/mri/a no follup imag    Final reports for ct, cta, mri or mra of the chest or neck or
   G9557          No Change       Ct/cta/mri/a no thyr <1.0cm    Final reports for ct, cta, mri or mra studies of the chest or
   G9558          No Change       Tx beta-lactam abx therapy     Patient treated with a beta-lactam antibiotic as definitive t
   G9559          No Change       Doc med reas no abx therapy    Documentation of medical reason(s) for not prescribing a beta
   G9560          No Change       No beta-lactam abx ther, rng   Patient not treated with a beta-lactam antibiotic as definiti
   G9561          No Change       Presc opiates >6 wks           Patients prescribed opiates for longer than six weeks
   G9562          No Change       Foll-up eval q3mo opiod tx     Patients who had a follow-up evaluation conducted at least ev
   G9563          No Change       No f/u eval q3mo opiod tx      Patients who did not have a follow-up evaluation conducted at
   G9572          No Change       Phq-scr >9 doc in 12m time     Index date phq-score greater than 9 documented during the twe
   G9577          No Change       Presc opiates >6 wks           Patients prescribed opiates for longer than six weeks
   G9578          No Change       Doc opioid tx 1x during ther   Documentation of signed opioid treatment agreement at least o
   G9579          No Change       No doc opioid tx 1x at ther    No documentation of signed an opioid treatment agreement at l
   G9580          No Change       Door to punc time <2hrs        Door to puncture time of less than 2 hours
   G9581          No Change       Md doc, door to punc tm >2hr   Door to puncture time of greater than 2 hours for reasons doc
   G9582          No Change       Door to punc time >2hr, nrg    Door to puncture time of greater than 2 hours, no reason give
   G9583          No Change       Presc opiates >6 wks           Patients prescribed opiates for longer than six weeks
   G9584          No Change       Eval opioid use instr/pt int   Patient evaluated for risk of misuse of opiates by using a br
   G9585          No Change       No eval opi use instr/intv     Patient not evaluated for risk of misuse of opiates by using
   G9593          No Change       Low pecarn ped head trauma     Pediatric patient with minor blunt head trauma classified as
   G9595          No Change       Doc shnt/tum/coag/thrombocyt   Patient has documentation of ventricular shunt, brain tumor,
   G9597          No Change       No low pecarn ped head traum   Pediatric patient with minor blunt head trauma not classified
   G9598          No Change       Aor ane 5.5-5.9 cm max diam    Aortic aneurysm 5.5 - 5.9 cm maximum diameter on centerline f
   G9599          No Change       Aor ane >=6.0 cm max diam      Aortic aneurysm 6.0 cm or greater maximum diameter on centerl
   G9600          No Change       Symp aaa urgent repair         Symptomatic aaas that required urgent/emergent (non-elective)
   G9601          No Change       Pt dchg home post op day 7     Patient discharge to home no later than post-operative day #7
   G9602          No Change       Pt no dchg home postop day 7   Patient not discharged to home by post-operative day #7
   G9603          No Change       Pt surv improv bsline tx       Patient survey score improved from baseline following treatme
   G9604          No Change       Pt surv results not avail      Patient survey results not available
   G9605          No Change       Surv score no improv w/tx      Patient survey score did not improve from baseline following
   G9606          No Change       Intraop cyst eval trac inj     Intraoperative cystoscopy performed to evaluate for lower tra
   G9607          No Change       Doc med rsn not perf cystosc   Documented medical reasons for not performing intraoperative
   G9608          No Change       Intraop cyst eval not done     Intraoperative cystoscopy not performed to evaluate for lower
   G9609          No Change       Doc order anti-plat            Documentation of an order for anti-platelet agents
   G9610          No Change       Doc md rsn no antipla          Documentation of medical reason(s) in the patient's record fo
   G9611          No Change       No doc order anti-plat rng     Order for anti-platelet agents was not documented in the pati
   G9613          No Change       Doc post surg anatomy          Documentation of post-surgical anatomy (e.g., right hemicolec
   G9615          No Change       Pre-op asst doc                Preoperative assessment documented
   G9616          No Change       Doc rsn no preop assmt         Documentation of reason(s) for not documenting a preoperative
   G9617          No Change       Pre-op asst not doc, rng       Preoperative assessment not documented, reason not given
   G9618          No Change       Doc scr uter mal or us/samp    Documentation of screening for uterine malignancy or those th
   G9619          No Change       Doc rsn no scr uter malig      Documentation of reason(s) for not screening for uterine mali
   G9620          No Change       No scr utr malig/us/samp rng   Patient not screened for uterine malignancy, or those that ha
   G9621          No Change       Scr unheal etoh w/counsel      Patient identified as an unhealthy alcohol user when screened
   G9622          No Change       No unheal etoh user            Patient not identified as an unhealthy alcohol user when scre
   G9623          No Change       Doc med rsn no scr etoh use    Documentation of medical reason(s) for not screening for unhe
   G9624          No Change       Pt not scrn or no counseling   Patient not screened for unhealthy alcohol use using a system
   G9626          No Change       Med rsn no rpt baldder inj     Documented medical reason for not reporting bladder injury (e
   G9629          No Change       Med rsn no rpt bowel inj       Documented medical reasons for not reporting bowel injury (e.
   G9632          No Change       Med rsn for no rpt uret inj    Documented medical reasons for not reporting ureter injury (e
   G9634          No Change       Qual life tool 2x same/impr    Health-related quality of life assessed with tool during at l
   G9635          No Change       No doc rsn do qual life assm   Health-related quality of life not assessed with tool for doc
   G9636          No Change       No life asst 2x same/decr      Health-related quality of life not assessed with tool during
   G9637          No Change       Doc >1 dose reduc tech         Final reports with documentation of one or more dose reductio
   G9638          No Change       No doc >1 dose reduc tech      Final reports without documentation of one or more dose reduc
   G9639          No Change       Amp no reqd in48h ieler proc   Major amputation or open surgical bypass not required within
   G9640          No Change       Doc plan hybrid/stage proc     Documentation of planned hybrid or staged procedure
   G9641          No Change       Amp reqd w/in 48h ieler proc   Major amputation or open surgical bypass required within 48 h
   G9642          No Change       Current smoker                 Current smokers (e.g., cigarette, cigar, pipe, e-cigarette or
   G9643          No Change       Elective surgery               Elective surgery
   G9644          No Change       No smok b/4 anes day of surg   Patients who abstained from smoking prior to anesthesia on th
   G9645          No Change       Had smoke b/4 anes day surg    Patients who did not abstain from smoking prior to anesthesia
   G9646          No Change       Pt w/90d mrs 0-2               Patients with 90 day mrs score of 0 to 2
   G9647          No Change       No mrs score in 90d followup   Patients in whom mrs score could not be obtained at 90 day fo
   G9648          No Change       Pt w/90d mrs >2                Patients with 90 day mrs score greater than 2
   G9650          No Change       Doc pt no ther chg or contra   Documentation that the patient declined therapy change or has
   G9652          No Change       Pt tx sys bio med psori 6mth   Patient has been treated with a systemic or biologic medicati
   G9653          No Change       Pt no tx sys bio rx 6 mths     Patient has not been treated with a systemic or biologic medi
   G9654          No Change       Mon anesth care                Monitored anesthesia care (mac)
   G9655          No Change       Toc tool incl key elem         A transfer of care protocol or handoff tool/checklist that in
   G9656          No Change       Pt trans from anest to pacu    Patient transferred directly from anesthetizing location to p
   G9657          No Change       Toc dur aneth to icu           Transfer of care during an anesthetic or to the intensive car
   G9658          No Change       Toc tool incl elem not used    A transfer of care protocol or handoff tool/checklist that in
   G9659          No Change       >85y no hx colo ca/rsn scope   Patients greater than 85 years of age who did not have a hist
   G9660          No Change       Doc med rsn scope pt >85y      Documentation of medical reason(s) for a colonoscopy performe
   G9661          No Change       >85y scope othr rsn            Patients greater than 85 years of age who received a routine
   G9662          No Change       Prior dx/active clin ascvd     Previously diagnosed or have an active diagnosis of clinical
   G9663          No Change       Fast/dir ldl = 190 mg/dl       Any fasting or direct ldl-c laboratory test result = 190 mg/d
   G9664          No Change       Taking statin or rec'd order   Patients who are currently statin therapy users or received a
   G9665          No Change       No statin/no order statin      Patients who are not currently statin therapy users or did no
   G9666          No Change       Fas/dir ldl 70-189mg/dl mst    The highest fasting or direct ldl-c laboratory test result of
   G9667          No Change       Doc med rsn no stat tx/presc   Documentation of medical reason(s) for not currently being a
   G9669          No Change       Intend rpt mult chr msr grp    I intend to report the multiple chronic conditions measures g
   G9670          No Change       Qty act mcc mg perf            All quality actions for the applicable measures in the multip
   G9671          No Change       Intend rpt dia retin msr grp   I intend to report the diabetic retinopathy measures group
   G9672          No Change       Qty act diab retin mg perf     All quality actions for the applicable measures in the diabet
   G9673          No Change       Intend rpt card prev msr grp   I intend to report the cardiovascular prevention measures gro
   G9674          No Change       Pt w/clin ascvd dx             Patients with clinical ascvd diagnosis
   G9675          No Change       Pt w/fast/dir lab ldl-c >190   Patients who have ever had a fasting or direct laboratory res
   G9676          No Change       40-75y w/type 1/2 w/ldl-c rs   Patients aged 40 to 75 years at the beginning of the measurem
   G9677          No Change       Qty act card prev mg perf      All quality actions for the applicable measures in the cardio
   G9678          No Change       Oncology care model service    Oncology care model (ocm) monthly enhanced oncology services
   G9679          No Change       Acute care pneumonia           This code is for onsite acute care treatment of a nursing fac
   G9680          No Change       Acute care congestive heart    This code is for onsite acute care treatment of a nursing fac
   G9681          No Change       Acute care chronic obstruct    This code is for onsite acute care treatment of a resident wi
   G9682          No Change       Acute care skin infection      This code is for the onsite acute care treatment a nursing fa
   G9684          No Change       Acute care urinary tract inf   This code is for the onsite acute care treatment of a nursing
   G9687          No Change       Hospice anytime msmt per       Hospice services provided to patient any time during the meas
   G9688          No Change       Pt w/hosp anytime msmt per     Patients using hospice services any time during the measureme
   G9689          No Change       Inpt elect carotid intervent   Patient admitted for performance of elective carotid interven
   G9691          No Change       Pt hosp dur msmt period        Patient had hospice services any time during the measurement
   G9692          No Change       Hosp recd by pt dur msmt per   Hospice services received by patient any time during the meas
   G9693          No Change       Pt use hosp during msmt per    Patient use of hospice services any time during the measureme
   G9694          No Change       Hosp srv used pt in msmt per   Hospice services utilized by patient any time during the meas
   G9695          No Change       Long act inhal bronchdil pre   Long-acting inhaled bronchodilator prescribed
   G9696          No Change       Med rsn no presc bronchdil     Documentation of medical reason(s) for not prescribing a long
   G9697          No Change       Pt rsn no presc bronchdil      Documentation of patient reason(s) for not prescribing a long
   G9698          No Change       Sys rsn no presc bronchdil     Documentation of system reason(s) for not prescribing a long-
   G9699          No Change       Long inhal bronchdil no pres   Long-acting inhaled bronchodilator not prescribed, reason not
   G9700          No Change       Pt is w/hosp during msmt per   Patients who use hospice services any time during the measure
   G9701          No Change       Child anbx 30 prior dx estab   Children who are taking antibiotics in the 30 days prior to t
   G9702          No Change       Pt use hosp during msmt per    Patients who use hospice services any time during the measure
   G9703          No Change       Child anbx 30 prior dx phary   Children who are taking antibiotics in the 30 days prior to t
   G9704          No Change       Ajcc br ca stg i: t1 mic/t1a   Ajcc breast cancer stage i: t1 mic or t1a documented
   G9705          No Change       Ajcc br ca stg ib              Ajcc breast cancer stage i: t1b (tumor > 0.5 cm but <= 1 cm i
   G9706          No Change       Low recur prost ca             Low (or very low) risk of recurrence, prostate cancer
   G9707          No Change       Pt had hosp dur msmt per       Patient received hospice services any time during the measure
   G9708          No Change       Bilat mast/hx bi /unilat mas   Women who had a bilateral mastectomy or who have a history of
   G9709          No Change       Hosp srv used pt in msmt per   Hospice services used by patient any time during the measurem
   G9710          No Change       Pt prov hosp srv msmt per      Patient was provided hospice services any time during the mea
   G9711          No Change       Pt hx tot col or colon ca      Patients with a diagnosis or past history of total colectomy
   G9712          No Change       Doc med rsn presc anbx         Documentation of medical reason(s) for prescribing or dispens
   G9713          No Change       Pt use hosp during msmt per    Patients who use hospice services any time during the measure
   G9714          No Change       Pt is w/hosp during msmt per   Patient is using hospice services any time during the measure
   G9715          No Change       Pt w/hosp anytime msmt per     Patients who use hospice services any time during the measure
   G9716          No Change       Bmi doc onl fup not cmpltd     Bmi is documented as being outside of normal limits, follow-u
   G9717          No Change       Doc pt dx dep/bp f/u nt req    Documentation stating the patient has an active diagnosis of
   G9718          No Change       Hospice anytime msmt per       Hospice services for patient provided any time during the mea
   G9719          No Change       Pt not ambul/immob/wc          Patient is not ambulatory, bed ridden, immobile, confined to
   G9720          No Change       Hospice anytime msmt per       Hospice services for patient occurred any time during the mea
   G9721          No Change       Pt not ambul/immob/wc          Patient not ambulatory, bed ridden, immobile, confined to cha
   G9722          No Change       Doc hx renal fail or cr+ >4    Documented history of renal failure or baseline serum creatin
   G9723          No Change       Hosp recd by pt dur msmt per   Hospice services for patient received any time during the mea
   G9724          No Change       Pt w/doc use anticoag mst yr   Patients who had documentation of use of anticoagulant medica
   G9725          No Change       Pt w/hosp anytime msmt per     Patients who use hospice services any time during the measure
   G9726          No Change       Refused to participate         Patient refused to participate
   G9728          No Change       Refused to participate         Patient refused to participate
   G9730          No Change       Refused to participate         Patient refused to participate
   G9732          No Change       Refused to participate         Patient refused to participate
   G9734          No Change       Refused to participate         Patient refused to participate
   G9736          No Change       Refused to participate         Patient refused to participate
   G9738          No Change       Refused to participate         Patient refused to participate
   G9740          No Change       Hosp srv to pt dur msmt per    Hospice services given to patient any time during the measure
   G9741          No Change       Pt w/hosp anytime msmt per     Patients who use hospice services any time during the measure
   G9742          No Change       Psych sympt assessed           Psychiatric symptoms assessed
   G9743          No Change       Psych symp not assessed, rns   Psychiatric symptoms not assessed, reason not otherwise speci
   G9744          No Change       Pt not eli d/t act dig htn     Patient not eligible due to active diagnosis of hypertension
   G9745          No Change       Doc rsn no hbp scrn or f/u     Documented reason for not screening or recommending a follow-
   G9746          No Change       Mit sten, valve or trans af    Patient has mitral stenosis or prosthetic heart valves or pat
   G9747          No Change       Pall dialysis with catheter    Patient is undergoing palliative dialysis with a catheter
   G9748          No Change       App transpl lvg kidney donor   Patient approved by a qualified transplant program and schedu
   G9749          No Change       Pall dialysis with catheter    Patient is undergoing palliative dialysis with a catheter
   G9750          No Change       App transpl lvg kidney donor   Patient approved by a qualified transplant program and schedu
   G9751          No Change       Pt died w/in 24 mos rpt time   Patient died at any time during the 24-month measurement peri
   G9752          No Change       Urgent surgery                 Emergency surgery
   G9753          No Change       Doc no dicom, ct other fac     Documentation of medical reason for not conducting a search f
   G9754          No Change       Incid pulm nodule              A finding of an incidental pulmonary nodule
   G9756          No Change       Surg proc w/silicone oil       Surgical procedures that included the use of silicone oil
   G9757          No Change       Surg proc w/silicone oil       Surgical procedures that included the use of silicone oil
   G9758          No Change       Pt in hos                      Patient in hospice at any time during the measurement period
   G9759          No Change       Hx preop post cap rup          History of preoperative posterior capsule rupture
   G9760          No Change       Pt w/hosp anytime msmt per     Patients who use hospice services any time during the measure
   G9761          No Change       Pt w/hosp anytime msmt per     Patients who use hospice services any time during the measure
   G9762          No Change       Pt had >= 2-3 hpv vaccines     Patient had at least two hpv vaccines (with at least 146 days
   G9763          No Change       Pt not have 2-3 hpv vaccines   Patient did not have at least two hpv vaccines (with at least
   G9766          No Change       Cva stroke dx tx transf fac    Patients who are transferred from one institution to another
   G9767          No Change       Hosp new dx cva consid evst    Hospitalized patients with newly diagnosed cva considered for
   G9768          No Change       Pt w/hosp anytime msmt per     Patients who utilize hospice services any time during the mea
   G9769          No Change       Bn den 2yr/got ost med/ther    Patient had a bone mineral density test in the past two years
   G9770          No Change       Perip nerve block              Peripheral nerve block (pnb)
   G9771          No Change       Anes end, 1 temp >35.5(95.9)   At least 1 body temperature measurement equal to or greater t
   G9774          No Change       Pt had hyst                    Patients who have had a hysterectomy
   G9775          No Change       Recd 2 anti-emet pre/intraop   Patient received at least 2 prophylactic pharmacologic anti-e
   G9776          No Change       Doc med rsn no proph antiem    Documentation of medical reason for not receiving at least 2
   G9777          No Change       Pt no antiemet pre/intraop     Patient did not receive at least 2 prophylactic pharmacologic
   G9778          No Change       Pts dx w/pregn                 Patients who have a diagnosis of pregnancy
   G9779          No Change       Pts breastfeeding              Patients who are breastfeeding
   G9780          No Change       Pts dx w/rhabdomyolysis        Patients who have a diagnosis of rhabdomyolysis
   G9781          No Change       Doc rsn no statin              Documentation of medical reason(s) for not currently being a
   G9782          No Change       Hx dx fam/pure hypercholes     History of or active diagnosis of familial or pure hyperchole
   G9783          No Change       Doc dx dm, fast <70, no stat   Documentation of patients with diabetes who have a most recen
   G9784          No Change       Path/derm prov 2nd biop opin   Pathologists/dermatopathologists providing a second opinion o
   G9785          No Change       Pathology report sent          Pathology report diagnosing cutaneous basal cell carcinoma or
   G9786          No Change       Pathology report not sent      Pathology report diagnosing cutaneous basal cell carcinoma or
   G9788          No Change       Most rct bp </= 140/90         Most recent bp is less than or equal to 140/90 mm hg
   G9789          No Change       Record bp ip, er, urg/self     Blood pressure recorded during inpatient stays, emergency roo
   G9790          No Change       Most rct bp >/= 140/90         Most recent bp is greater than 140/90 mm hg, or blood pressur
   G9791          No Change       Most rct tob stat free         Most recent tobacco status is tobacco free
   G9792          No Change       Most rct tob stat not free     Most recent tobacco status is not tobacco free
   G9793          No Change       Pt on daily asa/antiplat       Patient is currently on a daily aspirin or other antiplatelet
   G9794          No Change       Doc med rsn no daily aspirin   Documentation of medical reason(s) for not on a daily aspirin
   G9795          No Change       Pt no daily asa/antiplat       Patient is not currently on a daily aspirin or other antiplat
   G9796          No Change       Pt not currently on statin     Patient is currently on a statin therapy
   G9797          No Change       Pt currently on statin         Patient is not on a statin therapy
   G9798          No Change       D/c ami btw 7/1-6/30 mst per   Discharge(s) for ami between july 1 of the year prior measure
   G9799          No Change       Med disp evt indic hx asth     Patients with a medication dispensing event indicator of a hi
   G9800          No Change       Pt id intol/alleg beta-block   Patients who are identified as having an intolerance or aller
   G9801          No Change       Nonacut transf from inpt       Hospitalizations in which the patient was transferred directl
   G9802          No Change       Pt w/hosp anytime msmt per     Patients who use hospice services any time during the measure
   G9805          No Change       Pt w/hosp anytime msmt per     Patients who use hospice services any time during the measure
   G9806          No Change       Pt recd cerv cyto/hpv          Patients who received cervical cytology or an hpv test
   G9807          No Change       Pt no recd cerv cyto/hpv       Patients who did not receive cervical cytology or an hpv test
   G9808          No Change       Pt no asthm cont med mst per   Any patients who had no asthma controller medications dispens
   G9809          No Change       Pt w/hosp anytime msmt per     Patients who use hospice services any time during the measure
   G9810          No Change       Pdc 75% w/asth cont med        Patient achieved a pdc of at least 75% for their asthma contr
   G9811          No Change       No pdc 75% w/asth cont med     Patient did not achieve a pdc of at least 75% for their asthm
   G9812          No Change       Pt died during inpt/30d aft    Patient died including all deaths occurring during the hospit
   G9813          No Change       Pt not died w/in 30d of proc   Patient did not die within 30 days of the procedure or during
   G9814          No Change       Death during index hosp        Death occurring during the index acute care hospitalization
   G9815          No Change       Death not during index hosp    Death did not occur during the index acute care hospitalizati
   G9816          No Change       Death <30 day post discharge   Death occurring after discharge from the hospital but within
   G9817          No Change       No death 30-days post-disch    Death did not occur after discharge from the hospital within
   G9818          No Change       Doc sex activity               Documentation of sexual activity
   G9819          No Change       Pt w/hosp anytime msmt per     Patients who use hospice services any time during the measure
   G9820          No Change       Doc chlam scr test w/follow    Documentation of a chlamydia screening test with proper follo
   G9821          No Change       No doc chlam scr ts w/follow   No documentation of a chlamydia screening test with proper fo
   G9822          No Change       Endo abl proc yr prev ind dt   Women who had an endometrial ablation procedure during the ye
   G9823          No Change       Endo smpl/hyst bx res doc      Endometrial sampling or hysteroscopy with biopsy and results
   G9824          No Change       Endo smpl/hyst bx res no doc   Endometrial sampling or hysteroscopy with biopsy and results
   G9825          No Change       Her-2 neg,undoc/unkn           Her-2/neu negative or undocumented/unknown
   G9826          No Change       Transf pract aft init chemo    Patient transferred to practice after initiation of chemother
   G9827          No Change       Her-2 targ ther no init tx     Her2-targeted therapies not administered during the initial c
   G9828          No Change       Her-2 targ ther dur init tx    Her2-targeted therapies administered during the initial cours
   G9829          No Change       Breast adj chemo admin         Breast adjuvant chemotherapy administered
   G9830          No Change       Her-2 pos                      Her-2/neu positive
   G9831          No Change       Ajcc stg brt ca dx ii or iii   Ajcc stage at breast cancer diagnosis = ii or iii
   G9832          No Change       Brt ca dx i, no t1/t1a/t1b     Ajcc stage at breast cancer diagnosis = i (ia or ib) and t-st
   G9833          No Change       Transf pract aft init chemo    Patient transfer to practice after initiation of chemotherapy
   G9834          No Change       Pt met dis at dx               Patient has metastatic disease at diagnosis
   G9835          No Change       Trastuz given w/in 12 mos dx   Trastuzumab administered within 12 months of diagnosis
   G9836          No Change       Rsn no trast given doc         Reason for not administering trastuzumab documented (e.g. pat
   G9837          No Change       Trastuz not in 12 mos dx       Trastuzumab not administered within 12 months of diagnosis
   G9838          No Change       Pt met dis at dx               Patient has metastatic disease at diagnosis
   G9839          No Change       Anti-egfr mon anti ther        Anti-egfr monoclonal antibody therapy
   G9840          No Change       Gene testing performed         Ras (kras and nras) gene mutation testing performed before in
   G9841          No Change       Gene testing not performed     Ras (kras and nras) gene mutation testing not performed befor
   G9842          No Change       Pt met dis at dx               Patient has metastatic disease at diagnosis
   G9843          No Change       Kras or nras gene mutation     Ras (kras or nras) gene mutation
   G9844          No Change       Pt no recd anti-egfr ther      Patient did not receive anti-egfr monoclonal antibody therapy
   G9845          No Change       Pt recd anti-egfr ther         Patient received anti-egfr monoclonal antibody therapy
   G9846          No Change       Pt died from cancer            Patients who died from cancer
   G9847          No Change       Pt recd chemo last 14d life    Patient received chemotherapy in the last 14 days of life
   G9848          No Change       Pt no chemo last 14d life      Patient did not receive chemotherapy in the last 14 days of l
   G9849          No Change       Pt died from cancer            Patients who died from cancer
   G9850          No Change       1/more ed last 30d life        Patient had more than one emergency department visit in the l
   G9851          No Change       1/no ed visit last 30d life    Patient had one or less emergency department visits in the la
   G9852          No Change       Pt died from cancer            Patients who died from cancer
   G9853          No Change       Icu stay last 30d life         Patient admitted to the icu in the last 30 days of life
   G9854          No Change       No icu stay last 30d life      Patient was not admitted to the icu in the last 30 days of li
   G9855          No Change       Pt died from cancer            Patients who died from cancer
   G9856          No Change       Pt no hospice                  Patient was not admitted to hospice
   G9857          No Change       Pt admit hospice               Patient admitted to hospice
   G9858          No Change       Pt enroll hospice              Patient enrolled in hospice
   G9859          No Change       Pt died from cancer            Patients who died from cancer
   G9860          No Change       Pt less 3d hospice             Patient spent less than three days in hospice care
   G9861          No Change       Pt more than 3d hospice        Patient spent greater than or equal to three days in hospice
   G9862          No Change       Doc rsn no 10 yr follow        Documentation of medical reason(s) for not recommending at le
   G9868          No Change       Next gen aco model <10min      Receipt and analysis of remote, asynchronous images for derma
   G9869          No Change       Next gen aco model 10-20min    Receipt and analysis of remote, asynchronous images for derma
   G9870          No Change       Next gen aco model >20min      Receipt and analysis of remote, asynchronous images for derma
   G9892          No Change       Doc pt rsn no dil mac exam     Documentation of patient reason(s) for not performing a dilat
   G9893          No Change       No mac exam                    Dilated macular exam was not performed, reason not otherwise
   G9894          No Change       Adr dep thrpy prescribed       Androgen deprivation therapy prescribed/administered in combi
   G9895          No Change       Doc med rsn no adr dep thrpy   Documentation of medical reason(s) for not prescribing/admini
   G9896          No Change       Doc pt rsn no adr dep thrpy    Documentation of patient reason(s) for not prescribing/admini
   G9897          No Change       Pt nt prsc adr dep thrpy rng   Patients who were not prescribed/administered androgen depriv
   G9898          No Change       Snp/lg trm cre pt w/pos cde    Patient age 65 or older in institutional special needs plans
   G9899          No Change       Scrn mam perf rslts doc        Screening, diagnostic, film, digital or digital breast tomosy
   G9900          No Change       Scrn mam perf rslts not doc    Screening, diagnostic, film, digital or digital breast tomosy
   G9901          No Change       Snp/lg trm cre pt w/pos cde    Patient age 65 or older in institutional special needs plans
   G9902          No Change       Pt scrn tbco and id as user    Patient screened for tobacco use and identified as a tobacco
   G9903          No Change       Pt scrn tbco id as non user    Patient screened for tobacco use and identified as a tobacco
   G9904          No Change       Doc med rsn no tbco scrn       Documentation of medical reason(s) for not screening for toba
   G9905          No Change       No pt tbco scrn rng            Patient not screened for tobacco use, reason not given
   G9906          No Change       Pt recv tbco cess interv       Patient identified as a tobacco user received tobacco cessati
   G9907          No Change       Doc med rsn no tbco interv     Documentation of medical reason(s) for not providing tobacco
   G9908          No Change       No pt tbco cess interv rng     Patient identified as tobacco user did not receive tobacco ce
   G9909          No Change       Doc med rsn no tbco interv     Documentation of medical reason(s) for not  providing tobacco
   G9910          No Change       Snp/lg trm cre pt w/pos cde    Patients age 65 or older in institutional special needs plans
   G9911          No Change       Node neg pre/post syst ther    Clinically node negative (t1n0m0 or t2n0m0) invasive breast c
   G9912          No Change       Hbv status assesed and int     Hepatitis b virus (hbv) status assessed and results interpret
   G9913          No Change       No hbv status assesd and int   Hepatitis b virus (hbv) status not assessed and results inter
   G9914          No Change       Pt receiving anti-tnf agent    Patient receiving an anti-tnf agent
   G9915          No Change       No documntd hbv results rcd    No record of hbv results documented
   G9916          No Change       Funct status past 12 months    Functional status  performed once in the last 12 months
   G9917          No Change       Doc med rsn no funct status    Documentation of medical reason(s) for not performing functio
   G9918          No Change       No funct stat perf, rsn nos    Functional status not performed, reason not otherwise specifi
   G9919          No Change       Scrn nd pos nd prov of rec     Screening performed and positive and provision of recommendat
   G9920          No Change       Scrning perf and negative      Screening performed and negative
   G9921          No Change       No or part scrn nd rng or os   No screening performed, partial screening performed or positi
   G9922          No Change       Sfty cncrns scrn nd mit recs   Safety concerns screen provided and if positive then document
   G9923          No Change       Safty cncrns scrn and neg      Safety concerns screen provided and negative
   G9924          No Change       Doc med rsn no scrn or recs    Documentation of medical reason(s) for not providing safety c
   G9925          No Change       No scrn prov rsn nos           Safety concerns screening not provided, reason not otherwise
   G9926          No Change       Sfty cncrns scrn but no recs   Safety concerns screening positive screen is without provisio
   G9927          No Change       Doc no warf /fda  pt trial     Documentation of system reason(s) for not prescribing warfari
   G9928          No Change       No warf or fda drug presc      Warfarin or another fda-approved anticoagulant not prescribed
   G9929          No Change       Trs/rev af                     Patient with transient or reversible cause of af (e.g., pneum
   G9930          No Change       Com care                       Patients who are receiving comfort care only
   G9931          No Change       No chad or chad scr 0 or 1     Documentation of cha2ds2-vasc risk score of 0 or 1
   G9932          No Change       Doc pt rsn no tb scrn recrds   Documentation of patient reason(s) for not having records of
   G9933          No Change       Canc detectd during col scrn   Adenoma(s) or colorectal cancer detected during screening col
   G9934          No Change       Doc rsn not detecting cancer   Documentation that neoplasm detected is only diagnosed as tra
   G9935          No Change       Canc not detectd during srcn   Adenoma(s) or colorectal cancer not detected during screening
   G9936          No Change       Pmh plyp/neo co/rect/jun/ans   Surveillance colonoscopy - personal history of colonic polyps
   G9937          No Change       Dig or surv colsco             Diagnostic colonoscopy
   G9938          No Change       Snp/lg trm cre pt w/pos cde    Patients age 65 or older in institutional special needs plans
   G9939          No Change       Same path/derm perf biopsy     Pathologists/dermatopathologists is the same clinician who pe
   G9940          No Change       Doc reas no statin therapy     Documentation of medical reason(s) for not on a statin (e.g.,
   G9941          No Change       Pre and post vas wthn 3 mos    Back pain was measured by the visual analog scale (vas) withi
   G9942          No Change       Adtl spine proc on same date   Patient had any additional spine procedures performed on the
   G9943          No Change       Bk pn nt msr vas scl pre/pst   Back pain was not measured by the visual analog scale (vas) w
   G9944          No Change       Vas 3 mon pre and 1 yr post    Back pain was measured by the visual analog scale (vas) withi
   G9945          No Change       Pt w/cancer  scoliosis         Patient had cancer, fracture or infection related to the lumb
   G9946          No Change       Bk pn nt msr vas pre-pst 1y    Back pain was not measured by the visual analog scale (vas) w
   G9947          No Change       Pre and post vas wthn 3 mos    Leg pain was measured by the visual analog scale (vas) within
   G9948          No Change       Adtl spine proc on same date   Patient had any additional spine procedures performed on the
   G9949          No Change       Lg pn nt msr vas scl pre/pst   Leg pain was not measured by the visual analog scale (vas) wi
   G9954          No Change       Pt >2 rsk fac post-op vomit    Patient exhibits 2 or more risk factors for post-operative vo
   G9955          No Change       Inhlnt anesth only for induc   Cases in which an inhalational anesthetic is used only for in
   G9956          No Change       Combo thrpy of >= 2 prophly    Patient received combination therapy consisting of at least t
   G9957          No Change       Doc med rsn no combo thrpy     Documentation of medical reason for not receiving combination
   G9958          No Change       No combo prohpyl thrp for pt   Patient did not receive combination therapy consisting of at
   G9959          No Change       Systemic antimicro not presc   Systemic antimicrobials not prescribed
   G9960          No Change       Med rsn sys antimi nt rx       Documentation of medical reason(s) for prescribing systemic a
   G9961          No Change       Systemic antimicro presc       Systemic antimicrobials prescribed
   G9962          No Change       Embolization doc separatly     Embolization endpoints are documented separately for each emb
   G9963          No Change       Embolization not doc separat   Embolization endpoints are not documented separately for each
   G9964          No Change       Pt recv >=1 well-chld visit    Patient received at least one well-child visit with a pcp dur
   G9965          No Change       No well-chld vist recv by pt   Patient did not receive at least one well-child visit with a
   G9966          No Change       Scrn, inter, report child      Children who were screened for risk of developmental, behavio
   G9967          No Change       No scrn, inter, reprt child    Children who were not screened for risk of developmental, beh
   G9968          No Change       Pt refrd 2 pvdr/spclst in pp   Patient was referred to another provider or specialist during
   G9969          No Change       Pvdr rfrd pt rprt rcvd         Provider who referred the patient to another provider receive
   G9970          No Change       Pvdr rfrd pt no rprt rcvd      Provider who referred the patient to another provider did not
   H0001          No Change       Alcohol and/or drug assess     Alcohol and/or drug assessment
   H0002          No Change       Alcohol and/or drug screenin   Behavioral health screening to determine eligibility for admi
   H0003          No Change       Alcohol and/or drug screenin   Alcohol and/or drug screening; laboratory analysis of specime
   H0004          No Change       Alcohol and/or drug services   Behavioral health counseling and therapy, per 15 minutes
   H0005          No Change       Alcohol and/or drug services   Alcohol and/or drug services; group counseling by a clinician
   H0006          No Change       Alcohol and/or drug services   Alcohol and/or drug services; case management
   H0007          No Change       Alcohol and/or drug services   Alcohol and/or drug services; crisis intervention (outpatient
   H0008          No Change       Alcohol and/or drug services   Alcohol and/or drug services; sub-acute detoxification (hospi
   H0009          No Change       Alcohol and/or drug services   Alcohol and/or drug services; acute detoxification (hospital
   H0010          No Change       Alcohol and/or drug services   Alcohol and/or drug services; sub-acute detoxification (resid
   H0011          No Change       Alcohol and/or drug services   Alcohol and/or drug services; acute detoxification (residenti
   H0012          No Change       Alcohol and/or drug services   Alcohol and/or drug services; sub-acute detoxification (resid
   H0013          No Change       Alcohol and/or drug services   Alcohol and/or drug services; acute detoxification (residenti
   H0014          No Change       Alcohol and/or drug services   Alcohol and/or drug services; ambulatory detoxification
   H0015          No Change       Alcohol and/or drug services   Alcohol and/or drug services; intensive outpatient (treatment
   H0016          No Change       Alcohol and/or drug services   Alcohol and/or drug services; medical/somatic (medical interv
   H0017          No Change       Alcohol and/or drug services   Behavioral health; residential (hospital residential treatmen
   H0018          No Change       Alcohol and/or drug services   Behavioral health; short-term residential (non-hospital resid
   H0019          No Change       Alcohol and/or drug services   Behavioral health; long-term residential (non-medical, non-ac
   H0020          No Change       Alcohol and/or drug services   Alcohol and/or drug services; methadone administration and/or
   H0021          No Change       Alcohol and/or drug training   Alcohol and/or drug training service (for staff and personnel
   H0022          No Change       Alcohol and/or drug interven   Alcohol and/or drug intervention service (planned facilitatio
   H0023          No Change       Alcohol and/or drug outreach   Behavioral health outreach service (planned approach to reach
   H0024          No Change       Alcohol and/or drug preventi   Behavioral health prevention information dissemination servic
   H0025          No Change       Alcohol and/or drug preventi   Behavioral health prevention education service (delivery of s
   H0026          No Change       Alcohol and/or drug preventi   Alcohol and/or drug prevention process service, community-bas
   H0027          No Change       Alcohol and/or drug preventi   Alcohol and/or drug prevention environmental service (broad r
   H0028          No Change       Alcohol and/or drug preventi   Alcohol and/or drug prevention problem identification and ref
   H0029          No Change       Alcohol and/or drug preventi   Alcohol and/or drug prevention alternatives service (services
   H0030          No Change       Alcohol and/or drug hotline    Behavioral health hotline service
   H0031          No Change       Mh health assess by non-md     Mental health assessment, by non-physician
   H0032          No Change       Mh svc plan dev by non-md      Mental health service plan development by non-physician
   H0033          No Change       Oral med adm direct observe    Oral medication administration, direct observation
   H0034          No Change       Med trng & support per 15min   Medication training and support, per 15 minutes
   H0035          No Change       Mh partial hosp tx under 24h   Mental health partial hospitalization, treatment, less than 2
   H0036          No Change       Comm psy face-face per 15min   Community psychiatric supportive treatment, face-to-face, per
   H0037          No Change       Comm psy sup tx pgm per diem   Community psychiatric supportive treatment program, per diem
   H0038          No Change       Self-help/peer svc per 15min   Self-help/peer services, per 15 minutes
   H0039          No Change       Asser com tx face-face/15min   Assertive community treatment, face-to-face, per 15 minutes
   H0040          No Change       Assert comm tx pgm per diem    Assertive community treatment program, per diem
   H0041          No Change       Fos c chld non-ther per diem   Foster care, child, non-therapeutic, per diem
   H0042          No Change       Fos c chld non-ther per mon    Foster care, child, non-therapeutic, per month
   H0043          No Change       Supported housing, per diem    Supported housing, per diem
   H0044          No Change       Supported housing, per month   Supported housing, per month
   H0045          No Change       Respite not-in-home per diem   Respite care services, not in the home, per diem
   H0046          No Change       Mental health service, nos     Mental health services, not otherwise specified
   H0047          No Change       Alcohol/drug abuse svc nos     Alcohol and/or other drug abuse services, not otherwise speci
   H0048          No Change       Spec coll non-blood:a/d test   Alcohol and/or other drug testing: collection and handling on
   H0049          No Change       Alcohol/drug screening         Alcohol and/or drug screening
   H0050          No Change       Alcohol/drug service 15 min    Alcohol and/or drug services, brief intervention, per 15 minu
   H1000          No Change       Prenatal care atrisk assessm   Prenatal care, at-risk assessment
   H1001          No Change       Antepartum management          Prenatal care, at-risk enhanced service; antepartum managemen
   H1002          No Change       Carecoordination prenatal      Prenatal care, at risk enhanced service; care coordination
   H1003          No Change       Prenatal at risk education     Prenatal care, at-risk enhanced service; education
   H1004          No Change       Follow up home visit/prental   Prenatal care, at-risk enhanced service; follow-up home visit
   H1005          No Change       Prenatalcare enhanced srv pk   Prenatal care, at-risk enhanced service package (includes h10
   H1010          No Change       Nonmed family planning ed      Non-medical family planning education, per session
   H1011          No Change       Family assessment              Family assessment by licensed behavioral health professional
   H2000          No Change       Comp multidisipln evaluation   Comprehensive multidisciplinary evaluation
   H2001          No Change       Rehabilitation program 1/2 d   Rehabilitation program, per 1/2 day
   H2010          No Change       Comprehensive med svc 15 min   Comprehensive medication services, per 15 minutes
   H2011          No Change       Crisis interven svc, 15 min    Crisis intervention service, per 15 minutes
   H2012          No Change       Behav hlth day treat, per hr   Behavioral health day treatment, per hour
   H2013          No Change       Psych hlth fac svc, per diem   Psychiatric health facility service, per diem
   H2014          No Change       Skills train and dev, 15 min   Skills training and development, per 15 minutes
   H2015          No Change       Comp comm supp svc, 15 min     Comprehensive community support services, per 15 minutes
   H2016          No Change       Comp comm supp svc, per diem   Comprehensive community support services, per diem
   H2017          No Change       Psysoc rehab svc, per 15 min   Psychosocial rehabilitation services, per 15 minutes
   H2018          No Change       Psysoc rehab svc, per diem     Psychosocial rehabilitation services, per diem
   H2019          No Change       Ther behav svc, per 15 min     Therapeutic behavioral services, per 15 minutes
   H2020          No Change       Ther behav svc, per diem       Therapeutic behavioral services, per diem
   H2021          No Change       Com wrap-around sv, 15 min     Community-based wrap-around services, per 15 minutes
   H2022          No Change       Com wrap-around sv, per diem   Community-based wrap-around services, per diem
   H2023          No Change       Supported employ, per 15 min   Supported employment, per 15 minutes
   H2024          No Change       Supported employ, per diem     Supported employment, per diem
   H2025          No Change       Supp maint employ, 15 min      Ongoing support to maintain employment, per 15 minutes
   H2026          No Change       Supp maint employ, per diem    Ongoing support to maintain employment, per diem
   H2027          No Change       Psychoed svc, per 15 min       Psychoeducational service, per 15 minutes
   H2028          No Change       Sex offend tx svc, 15 min      Sexual offender treatment service, per 15 minutes
   H2029          No Change       Sex offend tx svc, per diem    Sexual offender treatment service, per diem
   H2030          No Change       Mh clubhouse svc, per 15 min   Mental health clubhouse services, per 15 minutes
   H2031          No Change       Mh clubhouse svc, per diem     Mental health clubhouse services, per diem
   H2032          No Change       Activity therapy, per 15 min   Activity therapy, per 15 minutes
   H2033          No Change       Multisys ther/juvenile 15min   Multisystemic therapy for juveniles, per 15 minutes
   H2034          No Change       A/d halfway house, per diem    Alcohol and/or drug abuse halfway house services, per diem
   H2035          No Change       A/d tx program, per hour       Alcohol and/or other drug treatment program, per hour
   H2036          No Change       A/d tx program, per diem       Alcohol and/or other drug treatment program, per diem
   H2037          No Change       Dev delay prev dp ch, 15 min   Developmental delay prevention activities, dependent child of
   J0120          No Change       Tetracyclin injection          Injection, tetracycline, up to 250 mg
   J0129          No Change       Abatacept injection            Injection, abatacept, 10 mg (code may be used for medicare wh
   J0130          No Change       Abciximab injection            Injection abciximab, 10 mg
   J0131          No Change       Acetaminophen injection        Injection, acetaminophen, 10 mg
   J0132          No Change       Acetylcysteine injection       Injection, acetylcysteine, 100 mg
   J0133          No Change       Acyclovir injection            Injection, acyclovir, 5 mg
   J0135          No Change       Adalimumab injection           Injection, adalimumab, 20 mg
   J0150          No Change       Injection adenosine 6 mg       Injection, adenosine for therapeutic use,  6 mg (not to be us
   J0151          No Change       Inj adenosine diag 1mg         Injection, adenosine for diagnostic use, 1 mg (not to be used
   J0153          No Change       Adenosine inj 1mg              Injection, adenosine, 1 mg (not to be used to report any aden
   J0171          No Change       Adrenalin epinephrine inject   Injection, adrenalin, epinephrine, 0.1 mg
   J0178          No Change       Aflibercept injection          Injection, aflibercept, 1 mg
   J0180          No Change       Agalsidase beta injection      Injection, agalsidase beta, 1 mg
   J0190          No Change       Inj biperiden lactate/5 mg     Injection, biperiden lactate, per 5 mg
   J0200          No Change       Alatrofloxacin mesylate        Injection, alatrofloxacin mesylate, 100 mg
   J0202          No Change       Injection, alemtuzumab         Injection, alemtuzumab, 1 mg
   J0205          No Change       Alglucerase injection          Injection, alglucerase, per 10 units
   J0207          No Change       Amifostine                     Injection, amifostine, 500 mg
   J0210          No Change       Methyldopate hcl injection     Injection, methyldopate hcl, up to 250 mg
   J0215          No Change       Alefacept                      Injection, alefacept, 0.5 mg
   J0220          No Change       Alglucosidase alfa injection   Injection, alglucosidase alfa, 10 mg, not otherwise specified
   J0221          No Change       Lumizyme injection             Injection, alglucosidase alfa, (lumizyme), 10 mg
   J0256          No Change       Alpha 1 proteinase inhibitor   Injection, alpha 1 proteinase inhibitor (human), not otherwis
   J0257          No Change       Glassia injection              Injection, alpha 1 proteinase inhibitor (human), (glassia), 1
   J0270          No Change       Alprostadil for injection      Injection, alprostadil, 1.25 mcg (code may be used for medica
   J0275          No Change       Alprostadil urethral suppos    Alprostadil urethral suppository (code may be used for medica
   J0278          No Change       Amikacin sulfate injection     Injection, amikacin sulfate, 100 mg
   J0280          No Change       Aminophyllin 250 mg inj        Injection, aminophyllin, up to 250 mg
   J0282          No Change       Amiodarone hcl                 Injection, amiodarone hydrochloride, 30 mg
   J0285          No Change       Amphotericin b                 Injection, amphotericin b, 50 mg
   J0287          No Change       Amphotericin b lipid complex   Injection, amphotericin b lipid complex, 10 mg
   J0288          No Change       Ampho b cholesteryl sulfate    Injection, amphotericin b cholesteryl sulfate complex, 10 mg
   J0289          No Change       Amphotericin b liposome inj    Injection, amphotericin b liposome, 10 mg
   J0290          No Change       Ampicillin 500 mg inj          Injection, ampicillin sodium, 500 mg
   J0300          No Change       Amobarbital 125 mg inj         Injection, amobarbital, up to 125 mg
   J0330          No Change       Succinycholine chloride inj    Injection, succinylcholine chloride, up to 20 mg
   J0348          No Change       Anidulafungin injection        Injection, anidulafungin, 1 mg
   J0350          No Change       Injection anistreplase 30 u    Injection, anistreplase, per 30 units
   J0360          No Change       Hydralazine hcl injection      Injection, hydralazine hcl, up to 20 mg
   J0364          No Change       Apomorphine hydrochloride      Injection, apomorphine hydrochloride, 1 mg
   J0365          No Change       Aprotonin, 10,000 kiu          Injection, aprotonin, 10,000 kiu
   J0380          No Change       Inj metaraminol bitartrate     Injection, metaraminol bitartrate, per 10 mg
   J0390          No Change       Chloroquine injection          Injection, chloroquine hydrochloride, up to 250 mg
   J0395          No Change       Arbutamine hcl injection       Injection, arbutamine hcl, 1 mg
   J0401          No Change       Inj aripiprazole ext rel 1mg   Injection, aripiprazole, extended release, 1 mg
   J0456          No Change       Azithromycin                   Injection, azithromycin, 500 mg
   J0461          No Change       Atropine sulfate injection     Injection, atropine sulfate, 0.01 mg
   J0475          No Change       Baclofen 10 mg injection       Injection, baclofen, 10 mg
   J0480          No Change       Basiliximab                    Injection, basiliximab, 20 mg
   J0485          No Change       Belatacept injection           Injection, belatacept, 1 mg
   J0490          No Change       Belimumab injection            Injection, belimumab, 10 mg
   J0500          No Change       Dicyclomine injection          Injection, dicyclomine hcl, up to 20 mg
   J0515          No Change       Inj benztropine mesylate       Injection, benztropine mesylate, per 1 mg
   J0520          No Change       Bethanechol chloride inject    Injection, bethanechol chloride, myotonachol or urecholine, u
   J0561          No Change       Penicillin g benzathine inj    Injection, penicillin g benzathine, 100,000 units
   J0565          No Change       Inj, bezlotoxumab, 10 mg       Injection, bezlotoxumab, 10 mg
   J0570          No Change       Buprenorphine implant 74.2mg   Buprenorphine implant, 74.2 mg
   J0571          No Change       Buprenorphine oral 1mg         Buprenorphine, oral, 1 mg
   J0572          No Change       Bupren/nal up to 3mg bupreno   Buprenorphine/naloxone, oral, less than or equal to 3 mg bupr
   J0573          No Change       Bupren/nal 3.1 to 6mg bupren   Buprenorphine/naloxone, oral, greater than 3 mg, but less tha
   J0574          No Change       Bupren/nal 6.1 to 10mg bupre   Buprenorphine/naloxone, oral, greater than 6 mg, but less tha
   J0575          No Change       Bupren/nal over 10mg bupreno   Buprenorphine/naloxone, oral, greater than 10 mg buprenorphin
   J0583          No Change       Bivalirudin                    Injection, bivalirudin, 1 mg
   J0585          No Change       Injection,onabotulinumtoxina   Injection, onabotulinumtoxina, 1 unit
   J0586          No Change       Abobotulinumtoxina             Injection, abobotulinumtoxina, 5 units
   J0587          No Change       Inj, rimabotulinumtoxinb       Injection, rimabotulinumtoxinb, 100 units
   J0588          No Change       Incobotulinumtoxin a           Injection, incobotulinumtoxin a, 1 unit
   J0592          No Change       Buprenorphine hydrochloride    Injection, buprenorphine hydrochloride, 0.1 mg
   J0594          No Change       Busulfan injection             injection, busulfan, 1 mg
   J0595          No Change       Butorphanol tartrate 1 mg      Injection, butorphanol tartrate, 1 mg
   J0596          No Change       Injection, ruconest            Injection, c1 esterase inhibitor (recombinant), ruconest, 10
   J0597          No Change       C-1 esterase, berinert         Injection, c-1 esterase inhibitor (human), berinert, 10 units
   J0598          No Change       C-1 esterase, cinryze          Injection, c-1 esterase inhibitor (human), cinryze, 10 units
   J0600          No Change       Edetate calcium disodium inj   Injection, edetate calcium disodium, up to 1000 mg
   J0604          No Change       Cinacalcet, esrd on dialysis   Cinacalcet, oral, 1 mg, (for esrd on dialysis)
   J0606          No Change       Inj, etelcalcetide, 0.1 mg     Injection, etelcalcetide, 0.1 mg
   J0610          No Change       Calcium gluconate injection    Injection, calcium gluconate, per 10 ml
   J0620          No Change       Calcium glycer & lact/10 ml    Injection, calcium glycerophosphate and calcium lactate, per
   J0630          No Change       Calcitonin salmon injection    Injection, calcitonin salmon, up to 400 units
   J0636          No Change       Inj calcitriol per 0.1 mcg     Injection, calcitriol, 0.1 mcg
   J0637          No Change       Caspofungin acetate            Injection, caspofungin acetate, 5 mg
   J0638          No Change       Canakinumab injection          Injection, canakinumab, 1 mg
   J0640          No Change       Leucovorin calcium injection   Injection, leucovorin calcium, per 50 mg
   J0641          No Change       Levoleucovorin injection       Injection, levoleucovorin calcium, 0.5 mg
   J0670          No Change       Inj mepivacaine hcl/10 ml      Injection, mepivacaine hydrochloride, per 10 ml
   J0690          No Change       Cefazolin sodium injection     Injection, cefazolin sodium, 500 mg
   J0692          No Change       Cefepime hcl for injection     Injection, cefepime hydrochloride, 500 mg
   J0694          No Change       Cefoxitin sodium injection     Injection, cefoxitin sodium, 1 gm
   J0695          No Change       Inj ceftolozane tazobactam     Injection, ceftolozane 50 mg and tazobactam 25 mg
   J0696          No Change       Ceftriaxone sodium injection   Injection, ceftriaxone sodium, per 250 mg
   J0697          No Change       Sterile cefuroxime injection   Injection, sterile cefuroxime sodium, per 750 mg
   J0698          No Change       Cefotaxime sodium injection    Injection, cefotaxime sodium, per gm
   J0702          No Change       Betamethasone acet&sod phosp   Injection, betamethasone acetate 3 mg and betamethasone sodiu
   J0706          No Change       Caffeine citrate injection     Injection, caffeine citrate, 5 mg
   J0710          No Change       Cephapirin sodium injection    Injection, cephapirin sodium, up to 1 gm
   J0712          No Change       Ceftaroline fosamil inj        Injection, ceftaroline fosamil, 10 mg
   J0713          No Change       Inj ceftazidime per 500 mg     Injection, ceftazidime, per 500 mg
   J0714          No Change       Ceftazidime and avibactam      Injection, ceftazidime and avibactam, 0.5 g/0.125 g
   J0715          No Change       Ceftizoxime sodium / 500 mg    Injection, ceftizoxime sodium, per 500 mg
   J0716          No Change       Centruroides immune f(ab)      Injection, centruroides immune f(ab)2, up to 120 milligrams
   J0717          No Change       Certolizumab pegol inj 1mg     Injection, certolizumab pegol, 1 mg (code may be used for med
   J0720          No Change       Chloramphenicol sodium injec   Injection, chloramphenicol sodium succinate, up to 1 gm
   J0735          No Change       Clonidine hydrochloride        Injection, clonidine hydrochloride, 1 mg
   J0740          No Change       Cidofovir injection            Injection, cidofovir, 375 mg
   J0743          No Change       Cilastatin sodium injection    Injection, cilastatin sodium; imipenem, per 250 mg
   J0744          No Change       Ciprofloxacin iv               Injection, ciprofloxacin for intravenous infusion, 200 mg
   J0745          No Change       Inj codeine phosphate /30 mg   Injection, codeine phosphate, per 30 mg
   J0760          No Change       Colchicine injection           Injection, colchicine, per 1 mg
   J0770          No Change       Colistimethate sodium inj      Injection, colistimethate sodium, up to 150 mg
   J0775          No Change       Collagenase, clost hist inj    Injection, collagenase, clostridium histolyticum, 0.01 mg
   J0780          No Change       Prochlorperazine injection     Injection, prochlorperazine, up to 10 mg
   J0795          No Change       Corticorelin ovine triflutal   Injection, corticorelin ovine triflutate, 1 microgram
   J0840          No Change       Crotalidae poly immune fab     Injection, crotalidae polyvalent immune fab (ovine), up to 1
   J0850          No Change       Cytomegalovirus imm iv /vial   Injection, cytomegalovirus immune globulin intravenous (human
   J0875          No Change       Injection, dalbavancin         Injection, dalbavancin, 5 mg
   J0878          No Change       Daptomycin injection           Injection, daptomycin, 1 mg
   J0881          No Change       Darbepoetin alfa, non-esrd     Injection, darbepoetin alfa, 1 microgram (non-esrd use)
   J0882          No Change       Darbepoetin alfa, esrd use     Injection, darbepoetin alfa, 1 microgram (for esrd on dialysi
   J0883          No Change       Argatroban nonesrd use 1mg     Injection, argatroban, 1 mg (for non-esrd use)
   J0884          No Change       Argatroban esrd dialysis 1mg   Injection, argatroban, 1 mg (for esrd on dialysis)
   J0885          No Change       Epoetin alfa, non-esrd         Injection, epoetin alfa, (for non-esrd use), 1000 units
   J0886          No Change       Epoetin alfa 1000 units esrd   Injection, epoetin alfa, 1000 units (for esrd on dialysis)
   J0887          No Change       Epoetin beta esrd use          Injection, epoetin beta, 1 microgram, (for esrd on dialysis)
   J0890          No Change       Peginesatide injection         Injection, peginesatide, 0.1 mg (for esrd on dialysis)
   J0894          No Change       Decitabine injection           Injection, decitabine, 1 mg
   J0895          No Change       Deferoxamine mesylate inj      Injection, deferoxamine mesylate, 500 mg
   J0897          No Change       Denosumab injection            Injection, denosumab, 1 mg
   J0900          No Change       Testosterone enanthate inj     Injection, testosterone enanthate and estradiol valerate, up
   J0945          No Change       Brompheniramine maleate inj    Injection, brompheniramine maleate, per 10 mg
   J1000          No Change       Depo-estradiol cypionate inj   Injection, depo-estradiol cypionate, up to 5 mg
   J1020          No Change       Methylprednisolone 20 mg inj   Injection, methylprednisolone acetate, 20 mg
   J1030          No Change       Methylprednisolone 40 mg inj   Injection, methylprednisolone acetate, 40 mg
   J1040          No Change       Methylprednisolone 80 mg inj   Injection, methylprednisolone acetate, 80 mg
   J1050          No Change       Medroxyprogesterone acetate    Injection, medroxyprogesterone acetate, 1 mg
   J1060          No Change       Testosterone cypionate 1 ml    Injection, testosterone cypionate and estradiol cypionate, up
   J1070          No Change       Testosterone cypionat 100 mg   Injection, testosterone cypionate, up to 100 mg
   J1071          No Change       Inj testosterone cypionate     Injection, testosterone cypionate, 1 mg
   J1080          No Change       Testosterone cypionat 200 mg   Injection, testosterone cypionate, 1 cc, 200 mg
   J1094          No Change       Inj dexamethasone acetate      Injection, dexamethasone acetate, 1 mg
   J1100          No Change       Dexamethasone sodium phos      Injection, dexamethasone sodium phosphate, 1 mg
   J1120          No Change       Acetazolamid sodium injectio   Injection, acetazolamide sodium, up to 500 mg
   J1160          No Change       Digoxin injection              Injection, digoxin, up to 0.5 mg
   J1162          No Change       Digoxin immune fab (ovine)     Injection, digoxin immune fab (ovine), per vial
   J1165          No Change       Phenytoin sodium injection     Injection, phenytoin sodium, per 50 mg
   J1170          No Change       Hydromorphone injection        Injection, hydromorphone, up to 4 mg
   J1180          No Change       Dyphylline injection           Injection, dyphylline, up to 500 mg
   J1190          No Change       Dexrazoxane hcl injection      Injection, dexrazoxane hydrochloride, per 250 mg
   J1200          No Change       Diphenhydramine hcl injectio   Injection, diphenhydramine hcl, up to 50 mg
   J1205          No Change       Chlorothiazide sodium inj      Injection, chlorothiazide sodium, per 500 mg
   J1212          No Change       Dimethyl sulfoxide 50% 50 ml   Injection, dmso, dimethyl sulfoxide, 50%, 50 ml
   J1230          No Change       Methadone injection            Injection, methadone hcl, up to 10 mg
   J1240          No Change       Dimenhydrinate injection       Injection, dimenhydrinate, up to 50 mg
   J1245          No Change       Dipyridamole injection         Injection, dipyridamole, per 10 mg
   J1250          No Change       Inj dobutamine hcl/250 mg      Injection, dobutamine hydrochloride, per 250 mg
   J1260          No Change       Dolasetron mesylate            Injection, dolasetron mesylate, 10 mg
   J1265          No Change       Dopamine injection             Injection, dopamine hcl, 40 mg
   J1267          No Change       Doripenem injection            Injection, doripenem, 10 mg
   J1270          No Change       Injection, doxercalciferol     Injection, doxercalciferol, 1 mcg
   J1290          No Change       Ecallantide injection          Injection, ecallantide, 1 mg
   J1300          No Change       Eculizumab injection           Injection, eculizumab, 10 mg
   J1320          No Change       Amitriptyline injection        Injection, amitriptyline hcl, up to 20 mg
   J1322          No Change       Elosulfase alfa, injection     Injection, elosulfase alfa, 1 mg
   J1324          No Change       Enfuvirtide injection          Injection, enfuvirtide, 1 mg
   J1325          No Change       Epoprostenol injection         Injection, epoprostenol, 0.5 mg
   J1327          No Change       Eptifibatide injection         Injection, eptifibatide, 5 mg
   J1330          No Change       Ergonovine maleate injection   Injection, ergonovine maleate, up to 0.2 mg
   J1335          No Change       Ertapenem injection            Injection, ertapenem sodium, 500 mg
   J1364          No Change       Erythro lactobionate /500 mg   Injection, erythromycin lactobionate, per 500 mg
   J1380          No Change       Estradiol valerate 10 mg inj   Injection, estradiol valerate, up to 10 mg
   J1410          No Change       Inj estrogen conjugate 25 mg   Injection, estrogen conjugated, per 25 mg
   J1428          No Change       Inj, eteplirsen, 10 mg         Injection, eteplirsen, 10 mg
   J1430          No Change       Ethanolamine oleate 100 mg     Injection, ethanolamine oleate, 100 mg
   J1435          No Change       Injection estrone per 1 mg     Injection, estrone, per 1 mg
   J1436          No Change       Etidronate disodium inj        Injection, etidronate disodium, per 300 mg
   J1438          No Change       Etanercept injection           Injection, etanercept, 25 mg (code may be used for medicare w
   J1439          No Change       Inj ferric carboxymaltos 1mg   Injection, ferric carboxymaltose, 1 mg
   J1442          No Change       Inj filgrastim excl biosimil   Injection, filgrastim (g-csf), excludes biosimilars, 1 microg
   J1443          No Change       Inj ferric pyrophosphate cit   Injection, ferric pyrophosphate citrate solution, 0.1 mg of i
   J1446          No Change       Inj, tbo-filgrastim, 5 mcg     Injection, tbo-filgrastim, 5 micrograms
   J1447          No Change       Inj tbo filgrastim 1 microg    Injection, tbo-filgrastim, 1 microgram
   J1450          No Change       Fluconazole                    Injection fluconazole, 200 mg
   J1451          No Change       Fomepizole, 15 mg              Injection, fomepizole, 15 mg
   J1452          No Change       Intraocular fomivirsen na      Injection, fomivirsen sodium, intraocular, 1.65 mg
   J1453          No Change       Fosaprepitant injection        Injection, fosaprepitant, 1 mg
   J1455          No Change       Foscarnet sodium injection     Injection, foscarnet sodium, per 1000 mg
   J1457          No Change       Gallium nitrate injection      Injection, gallium nitrate, 1 mg
   J1458          No Change       Galsulfase injection           Injection, galsulfase, 1 mg
   J1459          No Change       Inj ivig privigen 500 mg       Injection, immune globulin (privigen), intravenous, non-lyoph
   J1460          No Change       Gamma globulin 1 cc inj        Injection, gamma globulin, intramuscular, 1 cc
   J1555          No Change       Inj cuvitru, 100 mg            Injection, immune globulin (cuvitru), 100 mg
   J1556          No Change       Inj, imm glob bivigam, 500mg   Injection, immune globulin (bivigam), 500 mg
   J1557          No Change       Gammaplex injection            Injection, immune globulin, (gammaplex), intravenous, non-lyo
   J1559          No Change       Hizentra injection             Injection, immune globulin (hizentra), 100 mg
   J1560          No Change       Gamma globulin > 10 cc inj     Injection, gamma globulin, intramuscular, over 10 cc
   J1561          No Change       Gamunex-c/gammaked             Injection, immune globulin, (gamunex-c/gammaked), non-lyophil
   J1562          No Change       Vivaglobin, inj                Injection, immune globulin (vivaglobin), 100 mg
   J1566          No Change       Immune globulin, powder        Injection, immune globulin, intravenous, lyophilized (e.g., p
   J1568          No Change       Octagam injection              Injection, immune globulin, (octagam), intravenous, non-lyoph
   J1569          No Change       Gammagard liquid injection     Injection, immune globulin, (gammagard liquid), non-lyophiliz
   J1570          No Change       Ganciclovir sodium injection   Injection, ganciclovir sodium, 500 mg
   J1571          No Change       Hepagam b im injection         Injection, hepatitis b immune globulin (hepagam b), intramusc
   J1572          No Change       Flebogamma injection           Injection, immune globulin, (flebogamma/flebogamma dif), intr
   J1573          No Change       Hepagam b intravenous, inj     Injection, hepatitis b immune globulin (hepagam b), intraveno
   J1575          No Change       Hyqvia 100mg immuneglobulin    Injection, immune globulin/hyaluronidase, (hyqvia), 100 mg im
   J1580          No Change       Garamycin gentamicin inj       Injection, garamycin, gentamicin, up to 80 mg
   J1590          No Change       Gatifloxacin injection         Injection, gatifloxacin, 10 mg
   J1595          No Change       Injection glatiramer acetate   Injection, glatiramer acetate, 20 mg
   J1599          No Change       Ivig non-lyophilized, nos      Injection, immune globulin, intravenous, non-lyophilized (e.g
   J1600          No Change       Gold sodium thiomaleate inj    Injection, gold sodium thiomalate, up to 50 mg
   J1602          No Change       Golimumab for iv use 1mg       Injection, golimumab, 1 mg, for intravenous use
   J1610          No Change       Glucagon hydrochloride/1 mg    Injection, glucagon hydrochloride, per 1 mg
   J1620          No Change       Gonadorelin hydroch/ 100 mcg   Injection, gonadorelin hydrochloride, per 100 mcg
   J1626          No Change       Granisetron hcl injection      Injection, granisetron hydrochloride, 100 mcg
   J1627          No Change       Inj, granisetron, xr, 0.1 mg   Injection, granisetron, extended-release, 0.1 mg
   J1630          No Change       Haloperidol injection          Injection, haloperidol, up to 5 mg
   J1631          No Change       Haloperidol decanoate inj      Injection, haloperidol decanoate, per 50 mg
   J1640          No Change       Hemin, 1 mg                    Injection, hemin, 1 mg
   J1642          No Change       Inj heparin sodium per 10 u    Injection, heparin sodium, (heparin lock flush), per 10 units
   J1644          No Change       Inj heparin sodium per 1000u   Injection, heparin sodium, per 1000 units
   J1645          No Change       Dalteparin sodium              Injection, dalteparin sodium, per 2500 iu
   J1650          No Change       Inj enoxaparin sodium          Injection, enoxaparin sodium, 10 mg
   J1652          No Change       Fondaparinux sodium            Injection, fondaparinux sodium, 0.5 mg
   J1655          No Change       Tinzaparin sodium injection    Injection, tinzaparin sodium, 1000 iu
   J1670          No Change       Tetanus immune globulin inj    Injection, tetanus immune globulin, human, up to 250 units
   J1675          No Change       Histrelin acetate              Injection, histrelin acetate, 10 micrograms
   J1700          No Change       Hydrocortisone acetate inj     Injection, hydrocortisone acetate, up to 25 mg
   J1710          No Change       Hydrocortisone sodium ph inj   Injection, hydrocortisone sodium phosphate, up to 50 mg
   J1720          No Change       Hydrocortisone sodium succ i   Injection, hydrocortisone sodium succinate, up to 100 mg
   J1725          No Change       Hydroxyprogesterone caproate   Injection, hydroxyprogesterone caproate, 1 mg
   J1726          No Change       Makena, 10 mg                  Injection, hydroxyprogesterone caproate, (makena), 10 mg
   J1729          No Change       Inj hydroxyprogst capoat nos   Injection, hydroxyprogesterone caproate, not otherwise specif
   J1730          No Change       Diazoxide injection            Injection, diazoxide, up to 300 mg
   J1740          No Change       Ibandronate sodium injection   Injection, ibandronate sodium, 1 mg
   J1741          No Change       Ibuprofen injection            Injection, ibuprofen, 100 mg
   J1742          No Change       Ibutilide fumarate injection   Injection, ibutilide fumarate, 1 mg
   J1743          No Change       Idursulfase injection          Injection, idursulfase, 1 mg
   J1744          No Change       Icatibant injection            Injection, icatibant, 1 mg
   J1745          No Change       Infliximab not biosimil 10mg   Injection, infliximab, excludes biosimilar, 10 mg
   J1750          No Change       Inj iron dextran               Injection, iron dextran, 50 mg
   J1756          No Change       Iron sucrose injection         Injection, iron sucrose, 1 mg
   J1786          No Change       Imuglucerase injection         Injection, imiglucerase, 10 units
   J1790          No Change       Droperidol injection           Injection, droperidol, up to 5 mg
   J1800          No Change       Propranolol injection          Injection, propranolol hcl, up to 1 mg
   J1810          No Change       Droperidol/fentanyl inj        Injection, droperidol and fentanyl citrate, up to 2 ml ampule
   J1815          No Change       Insulin injection              Injection, insulin, per 5 units
   J1817          No Change       Insulin for insulin pump use   Insulin for administration through dme (i.e., insulin pump) p
   J1826          No Change       Interferon beta-1a inj         Injection, interferon beta-1a, 30 mcg
   J1830          No Change       Interferon beta-1b / .25 mg    Injection, interferon beta-1b, 0.25 mg (code may be used for
   J1833          No Change       Injection, isavuconazonium     Injection, isavuconazonium, 1 mg
   J1835          No Change       Itraconazole injection         Injection, itraconazole, 50 mg
   J1840          No Change       Kanamycin sulfate 500 mg inj   Injection, kanamycin sulfate, up to 500 mg
   J1850          No Change       Kanamycin sulfate 75 mg inj    Injection, kanamycin sulfate, up to 75 mg
   J1885          No Change       Ketorolac tromethamine inj     Injection, ketorolac tromethamine, per 15 mg
   J1890          No Change       Cephalothin sodium injection   Injection, cephalothin sodium, up to 1 gram
   J1930          No Change       Lanreotide injection           Injection, lanreotide, 1 mg
   J1931          No Change       Laronidase injection           Injection, laronidase, 0.1 mg
   J1940          No Change       Furosemide injection           Injection, furosemide, up to 20 mg
   J1942          No Change       Aripiprazole lauroxil 1mg      Injection, aripiprazole lauroxil, 1 mg
   J1945          No Change       Lepirudin                      Injection, lepirudin, 50 mg
   J1950          No Change       Leuprolide acetate /3.75 mg    Injection, leuprolide acetate (for depot suspension), per 3.7
   J1953          No Change       Levetiracetam injection        Injection, levetiracetam, 10 mg
   J1955          No Change       Inj levocarnitine per 1 gm     Injection, levocarnitine, per 1 gm
   J1956          No Change       Levofloxacin injection         Injection, levofloxacin, 250 mg
   J1960          No Change       Levorphanol tartrate inj       Injection, levorphanol tartrate, up to 2 mg
   J1980          No Change       Hyoscyamine sulfate inj        Injection, hyoscyamine sulfate, up to 0.25 mg
   J1990          No Change       Chlordiazepoxide injection     Injection, chlordiazepoxide hcl, up to 100 mg
   J2001          No Change       Lidocaine injection            Injection, lidocaine hcl for intravenous infusion, 10 mg
   J2010          No Change       Lincomycin injection           Injection, lincomycin hcl, up to 300 mg
   J2020          No Change       Linezolid injection            Injection, linezolid, 200 mg
   J2060          No Change       Lorazepam injection            Injection, lorazepam, 2 mg
   J2150          No Change       Mannitol injection             Injection, mannitol, 25% in 50 ml
   J2170          No Change       Mecasermin injection           Injection, mecasermin, 1 mg
   J2175          No Change       Meperidine hydrochl /100 mg    Injection, meperidine hydrochloride, per 100 mg
   J2180          No Change       Meperidine/promethazine inj    Injection, meperidine and promethazine hcl, up to 50 mg
   J2182          No Change       Injection, mepolizumab, 1mg    Injection, mepolizumab, 1 mg
   J2185          No Change       Meropenem                      Injection, meropenem, 100 mg
   J2210          No Change       Methylergonovin maleate inj    Injection, methylergonovine maleate, up to 0.2 mg
   J2212          No Change       Methylnaltrexone injection     Injection, methylnaltrexone, 0.1 mg
   J2248          No Change       Micafungin sodium injection    Injection, micafungin sodium, 1 mg
   J2250          No Change       Inj midazolam hydrochloride    Injection, midazolam hydrochloride, per 1 mg
   J2260          No Change       Inj milrinone lactate / 5 mg   Injection, milrinone lactate, 5 mg
   J2265          No Change       Minocycline hydrochloride      Injection, minocycline hydrochloride, 1 mg
   J2270          No Change       Morphine sulfate injection     Injection, morphine sulfate, up to 10 mg
   J2271          No Change       Morphine so4 injection 100mg   Injection, morphine sulfate, 100mg
   J2274          No Change       Inj morphine pf epid ithc      Injection, morphine sulfate, preservative-free for epidural o
   J2275          No Change       Morphine sulfate injection     Injection, morphine sulfate (preservative-free sterile soluti
   J2278          No Change       Ziconotide injection           Injection, ziconotide, 1 microgram
   J2280          No Change       Inj, moxifloxacin 100 mg       Injection, moxifloxacin, 100 mg
   J2300          No Change       Inj nalbuphine hydrochloride   Injection, nalbuphine hydrochloride, per 10 mg
   J2310          No Change       Inj naloxone hydrochloride     Injection, naloxone hydrochloride, per 1 mg
   J2315          No Change       Naltrexone, depot form         Injection, naltrexone, depot form, 1 mg
   J2320          No Change       Nandrolone decanoate 50 mg     Injection, nandrolone decanoate, up to 50 mg
   J2323          No Change       Natalizumab injection          Injection, natalizumab, 1 mg
   J2325          No Change       Nesiritide injection           Injection, nesiritide, 0.1 mg
   J2326          No Change       Inj, nusinersen, 0.1mg         Injection, nusinersen, 0.1 mg
   J2350          No Change       Injection, ocrelizumab, 1 mg   Injection, ocrelizumab, 1 mg
   J2353          No Change       Octreotide injection, depot    Injection, octreotide, depot form for intramuscular injection
   J2354          No Change       Octreotide inj, non-depot      Injection, octreotide, non-depot form for subcutaneous or int
   J2355          No Change       Oprelvekin injection           Injection, oprelvekin, 5 mg
   J2357          No Change       Omalizumab injection           Injection, omalizumab, 5 mg
   J2358          No Change       Olanzapine long-acting inj     Injection, olanzapine, long-acting, 1 mg
   J2360          No Change       Orphenadrine injection         Injection, orphenadrine citrate, up to 60 mg
   J2370          No Change       Phenylephrine hcl injection    Injection, phenylephrine hcl, up to 1 ml
   J2400          No Change       Chloroprocaine hcl injection   Injection, chloroprocaine hydrochloride, per 30 ml
   J2405          No Change       Ondansetron hcl injection      Injection, ondansetron hydrochloride, per 1 mg
   J2407          No Change       Injection, oritavancin         Injection, oritavancin, 10 mg
   J2410          No Change       Oxymorphone hcl injection      Injection, oxymorphone hcl, up to 1 mg
   J2425          No Change       Palifermin injection           Injection, palifermin, 50 micrograms
   J2426          No Change       Paliperidone palmitate inj     Injection, paliperidone palmitate extended release, 1 mg
   J2430          No Change       Pamidronate disodium /30 mg    Injection, pamidronate disodium, per 30 mg
   J2440          No Change       Papaverin hcl injection        Injection, papaverine hcl, up to 60 mg
   J2460          No Change       Oxytetracycline injection      Injection, oxytetracycline hcl, up to 50 mg
   J2469          No Change       Palonosetron hcl               Injection, palonosetron hcl, 25 mcg
   J2501          No Change       Paricalcitol                   Injection, paricalcitol, 1 mcg
   J2502          No Change       Inj, pasireotide long acting   Injection, pasireotide long acting, 1 mg
   J2504          No Change       Pegademase bovine, 25 iu       Injection, pegademase bovine, 25 iu
   J2505          No Change       Injection, pegfilgrastim 6mg   Injection, pegfilgrastim, 6 mg
   J2507          No Change       Pegloticase injection          Injection, pegloticase, 1 mg
   J2510          No Change       Penicillin g procaine inj      Injection, penicillin g procaine, aqueous, up to 600,000 unit
   J2513          No Change       Pentastarch 10% solution       Injection, pentastarch, 10% solution, 100 ml
   J2515          No Change       Pentobarbital sodium inj       Injection, pentobarbital sodium, per 50 mg
   J2540          No Change       Penicillin g potassium inj     Injection, penicillin g potassium, up to 600,000 units
   J2543          No Change       Piperacillin/tazobactam        Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.12
   J2545          No Change       Pentamidine non-comp unit      Pentamidine isethionate, inhalation solution, fda-approved fi
   J2547          No Change       Injection, peramivir           Injection, peramivir, 1 mg
   J2550          No Change       Promethazine hcl injection     Injection, promethazine hcl, up to 50 mg
   J2560          No Change       Phenobarbital sodium inj       Injection, phenobarbital sodium, up to 120 mg
   J2562          No Change       Plerixafor injection           Injection, plerixafor, 1 mg
   J2590          No Change       Oxytocin injection             Injection, oxytocin, up to 10 units
   J2597          No Change       Inj desmopressin acetate       Injection, desmopressin acetate, per 1 mcg
   J2650          No Change       Prednisolone acetate inj       Injection, prednisolone acetate, up to 1 ml
   J2670          No Change       Totazoline hcl injection       Injection, tolazoline hcl, up to 25 mg
   J2675          No Change       Inj progesterone per 50 mg     Injection, progesterone, per 50 mg
   J2680          No Change       Fluphenazine decanoate 25 mg   Injection, fluphenazine decanoate, up to 25 mg
   J2690          No Change       Procainamide hcl injection     Injection, procainamide hcl, up to 1 gm
   J2700          No Change       Oxacillin sodium injeciton     Injection, oxacillin sodium, up to 250 mg
   J2704          No Change       Inj, propofol, 10 mg           Injection, propofol, 10 mg
   J2710          No Change       Neostigmine methylslfte inj    Injection, neostigmine methylsulfate, up to 0.5 mg
   J2720          No Change       Inj protamine sulfate/10 mg    Injection, protamine sulfate, per 10 mg
   J2724          No Change       Protein c concentrate          Injection, protein c concentrate, intravenous, human, 10 iu
   J2725          No Change       Inj protirelin per 250 mcg     Injection, protirelin, per 250 mcg
   J2730          No Change       Pralidoxime chloride inj       Injection, pralidoxime chloride, up to 1 gm
   J2760          No Change       Phentolaine mesylate inj       Injection, phentolamine mesylate, up to 5 mg
   J2765          No Change       Metoclopramide hcl injection   Injection, metoclopramide hcl, up to 10 mg
   J2770          No Change       Quinupristin/dalfopristin      Injection, quinupristin/dalfopristin, 500 mg (150/350)
   J2778          No Change       Ranibizumab injection          Injection, ranibizumab, 0.1 mg
   J2780          No Change       Ranitidine hydrochloride inj   Injection, ranitidine hydrochloride, 25 mg
   J2783          No Change       Rasburicase                    Injection, rasburicase, 0.5 mg
   J2785          No Change       Regadenoson injection          Injection, regadenoson, 0.1 mg
   J2786          No Change       Injection, reslizumab, 1mg     Injection, reslizumab, 1 mg
   J2788          No Change       Rho d immune globulin 50 mcg   Injection, rho d immune globulin, human, minidose, 50 microgr
   J2790          No Change       Rho d immune globulin inj      Injection, rho d immune globulin, human, full dose, 300 micro
   J2791          No Change       Rhophylac injection            Injection, rho(d) immune globulin (human), (rhophylac), intra
   J2792          No Change       Rho(d) immune globulin h, sd   Injection, rho d immune globulin, intravenous, human, solvent
   J2794          No Change       Risperidone, long acting       Injection, risperidone, long acting, 0.5 mg
   J2795          No Change       Ropivacaine hcl injection      Injection, ropivacaine hydrochloride, 1 mg
   J2796          No Change       Romiplostim injection          Injection, romiplostim, 10 micrograms
   J2800          No Change       Methocarbamol injection        Injection, methocarbamol, up to 10 ml
   J2805          No Change       Sincalide injection            Injection, sincalide, 5 micrograms
   J2810          No Change       Inj theophylline per 40 mg     Injection, theophylline, per 40 mg
   J2820          No Change       Sargramostim injection         Injection, sargramostim (gm-csf), 50 mcg
   J2840          No Change       Inj sebelipase alfa 1 mg       Injection, sebelipase alfa, 1 mg
   J2850          No Change       Inj secretin synthetic human   Injection, secretin, synthetic, human, 1 microgram
   J2860          No Change       Injection, siltuximab          Injection, siltuximab, 10 mg
   J2910          No Change       Aurothioglucose injeciton      Injection, aurothioglucose, up to 50 mg
   J2916          No Change       Na ferric gluconate complex    Injection, sodium ferric gluconate complex in sucrose injecti
   J2920          No Change       Methylprednisolone injection   Injection, methylprednisolone sodium succinate, up to 40 mg
   J2930          No Change       Methylprednisolone injection   Injection, methylprednisolone sodium succinate, up to 125 mg
   J2940          No Change       Somatrem injection             Injection, somatrem, 1 mg
   J2950          No Change       Promazine hcl injection        Injection, promazine hcl, up to 25 mg
   J2993          No Change       Reteplase injection            Injection, reteplase, 18.1 mg
   J2995          No Change       Inj streptokinase /250000 iu   Injection, streptokinase, per 250,000 iu
   J2997          No Change       Alteplase recombinant          Injection, alteplase recombinant, 1 mg
   J3000          No Change       Streptomycin injection         Injection, streptomycin, up to 1 gm
   J3010          No Change       Fentanyl citrate injection     Injection, fentanyl citrate, 0.1 mg
   J3030          No Change       Sumatriptan succinate / 6 mg   Injection, sumatriptan succinate, 6 mg (code may be used for
   J3060          No Change       Inj, taliglucerase alfa 10 u   Injection, taliglucerase alfa, 10 units
   J3090          No Change       Inj tedizolid phosphate        Injection, tedizolid phosphate, 1 mg
   J3095          No Change       Telavancin injection           Injection, telavancin, 10 mg
   J3101          No Change       Tenecteplase injection         Injection, tenecteplase, 1 mg
   J3105          No Change       Terbutaline sulfate inj        Injection, terbutaline sulfate, up to 1 mg
   J3110          No Change       Teriparatide injection         Injection, teriparatide, 10 mcg
   J3120          No Change       Testosterone enanthate inj     Injection, testosterone enanthate, up to 100 mg
   J3121          No Change       Inj testostero enanthate 1mg   Injection, testosterone enanthate, 1 mg
   J3130          No Change       Testosterone enanthate inj     Injection, testosterone enanthate, up to 200 mg
   J3140          No Change       Testosterone suspension inj    Injection, testosterone suspension, up to 50 mg
   J3145          No Change       Testosterone undecanoate 1mg   Injection, testosterone undecanoate, 1 mg
   J3150          No Change       Testosteron propionate inj     Injection, testosterone propionate, up to 100 mg
   J3230          No Change       Chlorpromazine hcl injection   Injection, chlorpromazine hcl, up to 50 mg
   J3240          No Change       Thyrotropin injection          Injection, thyrotropin alpha, 0.9 mg, provided in 1.1 mg vial
   J3243          No Change       Tigecycline injection          Injection, tigecycline, 1 mg
   J3246          No Change       Tirofiban hcl                  Injection, tirofiban hcl, 0.25 mg
   J3250          No Change       Trimethobenzamide hcl inj      Injection, trimethobenzamide hcl, up to 200 mg
   J3260          No Change       Tobramycin sulfate injection   Injection, tobramycin sulfate, up to 80 mg
   J3262          No Change       Tocilizumab injection          Injection, tocilizumab, 1 mg
   J3265          No Change       Injection torsemide 10 mg/ml   Injection, torsemide, 10 mg/ml
   J3280          No Change       Thiethylperazine maleate inj   Injection, thiethylperazine maleate, up to 10 mg
   J3285          No Change       Treprostinil injection         Injection, treprostinil, 1 mg
   J3300          No Change       Triamcinolone a inj prs-free   Injection, triamcinolone acetonide, preservative free, 1 mg
   J3301          No Change       Triamcinolone acet inj nos     Injection, triamcinolone acetonide, not otherwise specified,
   J3302          No Change       Triamcinolone diacetate inj    Injection, triamcinolone diacetate, per 5 mg
   J3303          No Change       Triamcinolone hexacetonl inj   Injection, triamcinolone hexacetonide, per 5 mg
   J3305          No Change       Inj trimetrexate glucoronate   Injection, trimetrexate glucuronate, per 25 mg
   J3310          No Change       Perphenazine injeciton         Injection, perphenazine, up to 5 mg
   J3315          No Change       Triptorelin pamoate            Injection, triptorelin pamoate, 3.75 mg
   J3320          No Change       Spectinomycn di-hcl inj        Injection, spectinomycin dihydrochloride, up to 2 gm
   J3350          No Change       Urea injection                 Injection, urea, up to 40 gm
   J3355          No Change       Urofollitropin, 75 iu          Injection, urofollitropin, 75 iu
   J3357          No Change       Ustekinumab sub cu inj, 1 mg   Ustekinumab, for subcutaneous injection, 1 mg
   J3358          No Change       Ustekinumab, iv inject, 1 mg   Ustekinumab, for intravenous injection, 1 mg
   J3360          No Change       Diazepam injection             Injection, diazepam, up to 5 mg
   J3364          No Change       Urokinase 5000 iu injection    Injection, urokinase, 5000 iu vial
   J3365          No Change       Urokinase 250,000 iu inj       Injection, iv, urokinase, 250,000 i.u. vial
   J3370          No Change       Vancomycin hcl injection       Injection, vancomycin hcl, 500 mg
   J3380          No Change       Injection, vedolizumab         Injection, vedolizumab, 1 mg
   J3385          No Change       Velaglucerase alfa             Injection, velaglucerase alfa, 100 units
   J3396          No Change       Verteporfin injection          Injection, verteporfin, 0.1 mg
   J3400          No Change       Triflupromazine hcl inj        Injection, triflupromazine hcl, up to 20 mg
   J3410          No Change       Hydroxyzine hcl injection      Injection, hydroxyzine hcl, up to 25 mg
   J3411          No Change       Thiamine hcl 100 mg            Injection, thiamine hcl, 100 mg
   J3415          No Change       Pyridoxine hcl 100 mg          Injection, pyridoxine hcl, 100 mg
   J3420          No Change       Vitamin b12 injection          Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg
   J3430          No Change       Vitamin k phytonadione inj     Injection, phytonadione (vitamin k), per 1 mg
   J3470          No Change       Hyaluronidase injection        Injection, hyaluronidase, up to 150 units
   J3471          No Change       Ovine, up to 999 usp units     Injection, hyaluronidase, ovine, preservative free, per 1 usp
   J3472          No Change       Ovine, 1000 usp units          Injection, hyaluronidase, ovine, preservative free, per 1000
   J3473          No Change       Hyaluronidase recombinant      Injection, hyaluronidase, recombinant, 1 usp unit
   J3475          No Change       Inj magnesium sulfate          Injection, magnesium sulfate, per 500 mg
   J3480          No Change       Inj potassium chloride         Injection, potassium chloride, per 2 meq
   J3485          No Change       Zidovudine                     Injection, zidovudine, 10 mg
   J3486          No Change       Ziprasidone mesylate           Injection, ziprasidone mesylate, 10 mg
   J3489          No Change       Zoledronic acid 1mg            Injection, zoledronic acid, 1 mg
   J3490          No Change       Drugs unclassified injection   Unclassified drugs
   J3520          No Change       Edetate disodium per 150 mg    Edetate disodium, per 150 mg
   J3530          No Change       Nasal vaccine inhalation       Nasal vaccine inhalation
   J3535          No Change       Metered dose inhaler drug      Drug administered through a metered dose inhaler
   J3570          No Change       Laetrile amygdalin vit b17     Laetrile, amygdalin, vitamin b17
   J3590          No Change       Unclassified biologics         Unclassified biologics
   J7030          No Change       Normal saline solution infus   Infusion, normal saline solution , 1000 cc
   J7040          No Change       Normal saline solution infus   Infusion, normal saline solution, sterile (500 ml = 1 unit)
   J7042          No Change       5% dextrose/normal saline      5% dextrose/normal saline (500 ml = 1 unit)
   J7050          No Change       Normal saline solution infus   Infusion, normal saline solution, 250 cc
   J7060          No Change       5% dextrose/water              5% dextrose/water (500 ml = 1 unit)
   J7070          No Change       D5w infusion                   Infusion, d5w, 1000 cc
   J7100          No Change       Dextran 40 infusion            Infusion, dextran 40, 500 ml
   J7110          No Change       Dextran 75 infusion            Infusion, dextran 75, 500 ml
   J7120          No Change       Ringers lactate infusion       Ringers lactate infusion, up to 1000 cc
   J7121          No Change       5% dextrose in lac ringers     5% dextrose in lactated ringers infusion, up to 1000 cc
   J7131          No Change       Hypertonic saline sol          Hypertonic saline solution, 1 ml
   J7175          No Change       Inj, factor x, (human), 1iu    Injection, factor x, (human), 1 i.u.
   J7179          No Change       Vonvendi inj 1 iu vwf:rco      Injection, von willebrand factor (recombinant), (vonvendi), 1
   J7180          No Change       Factor xiii anti-hem factor    Injection, factor xiii (antihemophilic factor, human), 1 i.u.
   J7181          No Change       Factor xiii recomb a-subunit   Injection, factor xiii a-subunit, (recombinant), per iu
   J7182          No Change       Factor viii recomb novoeight   Injection, factor viii, (antihemophilic factor, recombinant),
   J7183          No Change       Wilate injection               Injection, von willebrand factor complex (human), wilate, 1 i
   J7185          No Change       Xyntha inj                     Injection, factor viii (antihemophilic factor, recombinant) (
   J7186          No Change       Antihemophilic viii/vwf comp   Injection, antihemophilic factor viii/von willebrand factor c
   J7187          No Change       Humate-p, inj                  Injection, von willebrand factor complex (humate-p), per iu v
   J7188          No Change       Factor viii recomb obizur      Injection, factor viii (antihemophilic factor, recombinant),
   J7189          No Change       Factor viia                    Factor viia (antihemophilic factor, recombinant), per 1 micro
   J7190          No Change       Factor viii                    Factor viii (antihemophilic factor, human) per i.u.
   J7191          No Change       Factor viii (porcine)          Factor viii (antihemophilic factor (porcine)), per i.u.
   J7192          No Change       Factor viii recombinant nos    Factor viii (antihemophilic factor, recombinant) per i.u., no
   J7193          No Change       Factor ix non-recombinant      Factor ix (antihemophilic factor, purified, non-recombinant)
   J7194          No Change       Factor ix complex              Factor ix, complex, per i.u.
   J7195          No Change       Factor ix recombinant nos      Injection, factor ix (antihemophilic factor, recombinant) per
   J7196          No Change       Antithrombin recombinant       Injection, antithrombin recombinant, 50 i.u.
   J7197          No Change       Antithrombin iii injection     Antithrombin iii (human), per i.u.
   J7198          No Change       Anti-inhibitor                 Anti-inhibitor, per i.u.
   J7199          No Change       Hemophilia clot factor noc     Hemophilia clotting factor, not otherwise classified
   J7200          No Change       Factor ix recombinan rixubis   Injection, factor ix, (antihemophilic factor, recombinant), r
   J7201          No Change       Factor ix alprolix recomb      Injection, factor ix, fc fusion protein, (recombinant), alpro
   J7202          No Change       Factor ix idelvion inj         Injection, factor ix, albumin fusion protein, (recombinant),
   J7205          No Change       Factor viii fc fusion recomb   Injection, factor viii fc fusion protein (recombinant), per i
   J7207          No Change       Factor viii pegylated recomb   Injection, factor viii, (antihemophilic factor, recombinant),
   J7209          No Change       Factor viii nuwiq recomb 1iu   Injection, factor viii, (antihemophilic factor, recombinant),
   J7210          No Change       Inj, afstyla, 1 i.u.           Injection, factor viii, (antihemophilic factor, recombinant),
   J7211          No Change       Inj, kovaltry, 1 i.u.          Injection, factor viii, (antihemophilic factor, recombinant),
   J7296          No Change       Kyleena, 19.5 mg               Levonorgestrel-releasing intrauterine contraceptive system, (
   J7297          No Change       Liletta, 52 mg                 Levonorgestrel-releasing intrauterine contraceptive system (l
   J7298          No Change       Mirena, 52 mg                  Levonorgestrel-releasing intrauterine contraceptive system (m
   J7300          No Change       Intraut copper contraceptive   Intrauterine copper contraceptive
   J7301          No Change       Skyla, 13.5 mg                 Levonorgestrel-releasing intrauterine contraceptive system (s
   J7302          No Change       Levonorgestrel iu 52 mg        Levonorgestrel-releasing intrauterine contraceptive system, 5
   J7303          No Change       Contraceptive vaginal ring     Contraceptive supply, hormone containing vaginal ring, each
   J7304          No Change       Contraceptive hormone patch    Contraceptive supply, hormone containing patch, each
   J7306          No Change       Levonorgestrel implant sys     Levonorgestrel (contraceptive) implant system, including impl
   J7307          No Change       Etonogestrel implant system    Etonogestrel (contraceptive) implant system, including implan
   J7308          No Change       Aminolevulinic acid hcl top    Aminolevulinic acid hcl for topical administration, 20%, sing
   J7309          No Change       Methyl aminolevulinate, top    Methyl aminolevulinate (mal) for topical administration, 16.8
   J7310          No Change       Ganciclovir long act implant   Ganciclovir, 4.5 mg, long-acting implant
   J7311          No Change       Fluocinolone acetonide implt   Fluocinolone acetonide, intravitreal implant
   J7312          No Change       Dexamethasone intra implant    Injection, dexamethasone, intravitreal implant, 0.1 mg
   J7313          No Change       Fluocinol acet intravit imp    Injection, fluocinolone acetonide, intravitreal implant, 0.01
   J7315          No Change       Ophthalmic mitomycin           Mitomycin, ophthalmic, 0.2 mg
   J7316          No Change       Inj, ocriplasmin, 0.125 mg     Injection, ocriplasmin, 0.125 mg
   J7320          No Change       Genvisc 850, inj, 1mg          Hyaluronan or derivitive, genvisc 850, for intra-articular in
   J7321          No Change       Hyalgan supartz visco-3 dose   Hyaluronan or derivative, hyalgan, supartz or visco-3, for in
   J7322          No Change       Hymovis injection 1 mg         Hyaluronan or derivative, hymovis, for intra-articular inject
   J7323          No Change       Euflexxa inj per dose          Hyaluronan or derivative, euflexxa, for intra-articular injec
   J7324          No Change       Orthovisc inj per dose         Hyaluronan or derivative, orthovisc, for intra-articular inje
   J7325          No Change       Synvisc or synvisc-one         Hyaluronan or derivative, synvisc or synvisc-one, for intra-a
   J7326          No Change       Gel-one                        Hyaluronan or derivative, gel-one, for intra-articular inject
   J7327          No Change       Monovisc inj per dose          Hyaluronan or derivative, monovisc, for intra-articular injec
   J7328          No Change       Gelsyn-3 injection 0.1 mg      Hyaluronan or derivative, gelsyn-3, for intra-articular injec
   J7330          No Change       Cultured chondrocytes implnt   Autologous cultured chondrocytes, implant
   J7335          No Change       Capsaicin 8% patch             Capsaicin 8% patch, per 10 square centimeters
   J7336          No Change       Capsaicin 8% patch             Capsaicin 8% patch, per square centimeter
   J7342          No Change       Ciprofloxacin otic susp 6 mg   Instillation, ciprofloxacin otic suspension, 6 mg
   J7345          No Change       Aminolevulinic acid, 10% gel   Aminolevulinic acid hcl for topical administration, 10% gel,
   J7500          No Change       Azathioprine oral 50mg         Azathioprine, oral, 50 mg
   J7501          No Change       Azathioprine parenteral        Azathioprine, parenteral, 100 mg
   J7502          No Change       Cyclosporine oral 100 mg       Cyclosporine, oral, 100 mg
   J7504          No Change       Lymphocyte immune globulin     Lymphocyte immune globulin, antithymocyte globulin, equine, p
   J7506          No Change       Prednisone oral                Prednisone, oral, per 5 mg
   J7507          No Change       Tacrolimus imme rel oral 1mg   Tacrolimus, immediate release, oral, 1 mg
   J7508          No Change       Tacrol astagraf ex rel oral    Tacrolimus, extended release, (astagraf xl), oral, 0.1 mg
   J7509          No Change       Methylprednisolone oral        Methylprednisolone oral, per 4 mg
   J7510          No Change       Prednisolone oral per 5 mg     Prednisolone oral, per 5 mg
   J7511          No Change       Antithymocyte globuln rabbit   Lymphocyte immune globulin, antithymocyte globulin, rabbit, p
   J7512          No Change       Prednisone ir or dr oral 1mg   Prednisone, immediate release or delayed release, oral, 1 mg
   J7513          No Change       Daclizumab, parenteral         Daclizumab, parenteral, 25 mg
   J7515          No Change       Cyclosporine oral 25 mg        Cyclosporine, oral, 25 mg
   J7516          No Change       Cyclosporin parenteral 250mg   Cyclosporin, parenteral, 250 mg
   J7517          No Change       Mycophenolate mofetil oral     Mycophenolate mofetil, oral, 250 mg
   J7518          No Change       Mycophenolic acid              Mycophenolic acid, oral, 180 mg
   J7520          No Change       Sirolimus, oral                Sirolimus, oral, 1 mg
   J7525          No Change       Tacrolimus injection           Tacrolimus, parenteral, 5 mg
   J7527          No Change       Oral everolimus                Everolimus, oral, 0.25 mg
   J7599          No Change       Immunosuppressive drug noc     Immunosuppressive drug, not otherwise classified
   J7604          No Change       Acetylcysteine comp unit       Acetylcysteine, inhalation solution, compounded product, admi
   J7605          No Change       Arformoterol non-comp unit     Arformoterol, inhalation solution, fda approved final product
   J7606          No Change       Formoterol fumarate, inh       Formoterol fumarate, inhalation solution, fda approved final
   J7607          No Change       Levalbuterol comp con          Levalbuterol, inhalation solution, compounded product, admini
   J7608          No Change       Acetylcysteine non-comp unit   Acetylcysteine, inhalation solution, fda-approved final produ
   J7609          No Change       Albuterol comp unit            Albuterol, inhalation solution, compounded product, administe
   J7610          No Change       Albuterol comp con             Albuterol, inhalation solution, compounded product, administe
   J7611          No Change       Albuterol non-comp con         Albuterol, inhalation solution, fda-approved final product, n
   J7612          No Change       Levalbuterol non-comp con      Levalbuterol, inhalation solution, fda-approved final product
   J7613          No Change       Albuterol non-comp unit        Albuterol, inhalation solution, fda-approved final product, n
   J7614          No Change       Levalbuterol non-comp unit     Levalbuterol, inhalation solution, fda-approved final product
   J7615          No Change       Levalbuterol comp unit         Levalbuterol, inhalation solution, compounded product, admini
   J7620          No Change       Albuterol ipratrop non-comp    Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg
   J7622          No Change       Beclomethasone comp unit       Beclomethasone, inhalation solution, compounded product, admi
   J7624          No Change       Betamethasone comp unit        Betamethasone, inhalation solution, compounded product, admin
   J7626          No Change       Budesonide non-comp unit       Budesonide, inhalation solution, fda-approved final product,
   J7627          No Change       Budesonide comp unit           Budesonide, inhalation solution, compounded product, administ
   J7628          No Change       Bitolterol mesylate comp con   Bitolterol mesylate, inhalation solution, compounded product,
   J7629          No Change       Bitolterol mesylate comp unt   Bitolterol mesylate, inhalation solution, compounded product,
   J7631          No Change       Cromolyn sodium noncomp unit   Cromolyn sodium, inhalation solution, fda-approved final prod
   J7632          No Change       Cromolyn sodium comp unit      Cromolyn sodium, inhalation solution, compounded product, adm
   J7633          No Change       Budesonide non-comp con        Budesonide, inhalation solution, fda-approved final product,
   J7634          No Change       Budesonide comp con            Budesonide, inhalation solution, compounded product, administ
   J7635          No Change       Atropine comp con              Atropine, inhalation solution, compounded product, administer
   J7636          No Change       Atropine comp unit             Atropine, inhalation solution, compounded product, administer
   J7637          No Change       Dexamethasone comp con         Dexamethasone, inhalation solution, compounded product, admin
   J7638          No Change       Dexamethasone comp unit        Dexamethasone, inhalation solution, compounded product, admin
   J7639          No Change       Dornase alfa non-comp unit     Dornase alfa, inhalation solution, fda-approved final product
   J7640          No Change       Formoterol comp unit           Formoterol, inhalation solution, compounded product, administ
   J7641          No Change       Flunisolide comp unit          Flunisolide, inhalation solution, compounded product, adminis
   J7642          No Change       Glycopyrrolate comp con        Glycopyrrolate, inhalation solution, compounded product, admi
   J7643          No Change       Glycopyrrolate comp unit       Glycopyrrolate, inhalation solution, compounded product, admi
   J7644          No Change       Ipratropium bromide non-comp   Ipratropium bromide, inhalation solution, fda-approved final
   J7645          No Change       Ipratropium bromide comp       Ipratropium bromide, inhalation solution, compounded product,
   J7647          No Change       Isoetharine comp con           Isoetharine hcl, inhalation solution, compounded product, adm
   J7648          No Change       Isoetharine non-comp con       Isoetharine hcl, inhalation solution, fda-approved final prod
   J7649          No Change       Isoetharine non-comp unit      Isoetharine hcl, inhalation solution, fda-approved final prod
   J7650          No Change       Isoetharine comp unit          Isoetharine hcl, inhalation solution, compounded product, adm
   J7657          No Change       Isoproterenol comp con         Isoproterenol hcl, inhalation solution, compounded product, a
   J7658          No Change       Isoproterenol non-comp con     Isoproterenol hcl, inhalation solution, fda-approved final pr
   J7659          No Change       Isoproterenol non-comp unit    Isoproterenol hcl, inhalation solution, fda-approved final pr
   J7660          No Change       Isoproterenol comp unit        Isoproterenol hcl, inhalation solution, compounded product, a
   J7665          No Change       Mannitol for inhaler           Mannitol, administered through an inhaler, 5 mg
   J7667          No Change       Metaproterenol comp con        Metaproterenol sulfate, inhalation solution, compounded produ
   J7668          No Change       Metaproterenol non-comp con    Metaproterenol sulfate, inhalation solution, fda-approved fin
   J7669          No Change       Metaproterenol non-comp unit   Metaproterenol sulfate, inhalation solution, fda-approved fin
   J7670          No Change       Metaproterenol comp unit       Metaproterenol sulfate, inhalation solution, compounded produ
   J7674          No Change       Methacholine chloride, neb     Methacholine chloride administered as inhalation solution thr
   J7676          No Change       Pentamidine comp unit dose     Pentamidine isethionate, inhalation solution, compounded prod
   J7680          No Change       Terbutaline sulf comp con      Terbutaline sulfate, inhalation solution, compounded product,
   J7681          No Change       Terbutaline sulf comp unit     Terbutaline sulfate, inhalation solution, compounded product,
   J7682          No Change       Tobramycin non-comp unit       Tobramycin, inhalation solution, fda-approved final product,
   J7683          No Change       Triamcinolone comp con         Triamcinolone, inhalation solution, compounded product, admin
   J7684          No Change       Triamcinolone comp unit        Triamcinolone, inhalation solution, compounded product, admin
   J7685          No Change       Tobramycin comp unit           Tobramycin, inhalation solution, compounded product, administ
   J7686          No Change       Treprostinil, non-comp unit    Treprostinil, inhalation solution, fda-approved final product
   J7699          No Change       Inhalation solution for dme    Noc drugs, inhalation solution administered through dme
   J7799          No Change       Non-inhalation drug for dme    Noc drugs, other than inhalation drugs, administered through
   J7999          No Change       Compounded drug, noc           Compounded drug, not otherwise classified
   J8498          No Change       Antiemetic rectal/supp nos     Antiemetic drug, rectal/suppository, not otherwise specified
   J8499          No Change       Oral prescrip drug non chemo   Prescription drug, oral, non chemotherapeutic, nos
   J8510          No Change       Oral busulfan                  Busulfan; oral, 2 mg
   J8515          No Change       Cabergoline, oral 0.25mg       Cabergoline, oral, 0.25 mg
   J8520          No Change       Capecitabine, oral, 150 mg     Capecitabine, oral, 150 mg
   J8521          No Change       Capecitabine, oral, 500 mg     Capecitabine, oral, 500 mg
   J8530          No Change       Cyclophosphamide oral 25 mg    Cyclophosphamide; oral, 25 mg
   J8540          No Change       Oral dexamethasone             Dexamethasone, oral, 0.25 mg
   J8560          No Change       Etoposide oral 50 mg           Etoposide; oral, 50 mg
   J8565          No Change       Gefitinib oral                 Gefitinib, oral, 250 mg
   J8597          No Change       Antiemetic drug oral nos       Antiemetic drug, oral, not otherwise specified
   J8610          No Change       Methotrexate oral 2.5 mg       Methotrexate; oral, 2.5 mg
   J8650          No Change       Nabilone oral                  Nabilone, oral, 1 mg
   J8670          No Change       Rolapitant, oral, 1mg          Rolapitant, oral, 1 mg
   J8700          No Change       Temozolomide                   Temozolomide, oral, 5 mg
   J8999          No Change       Oral prescription drug chemo   Prescription drug, oral, chemotherapeutic, nos
   J9000          No Change       Doxorubicin hcl injection      Injection, doxorubicin hydrochloride, 10 mg
   J9010          No Change       Alemtuzumab injection          Injection, alemtuzumab, 10 mg
   J9015          No Change       Aldesleukin injection          Injection, aldesleukin, per single use vial
   J9017          No Change       Arsenic trioxide injection     Injection, arsenic trioxide, 1 mg
   J9019          No Change       Erwinaze injection             Injection, asparaginase (erwinaze), 1,000 iu
   J9020          No Change       Asparaginase, nos              Injection, asparaginase, not otherwise specified, 10,000 unit
   J9022          No Change       Inj, atezolizumab,10 mg        Injection, atezolizumab, 10 mg
   J9023          No Change       Injection, avelumab, 10 mg     Injection, avelumab, 10 mg
   J9025          No Change       Azacitidine injection          Injection, azacitidine, 1 mg
   J9027          No Change       Clofarabine injection          Injection, clofarabine, 1 mg
   J9031          No Change       Bcg live intravesical vac      Bcg (intravesical) per instillation
   J9032          No Change       Injection, belinostat, 10mg    Injection, belinostat, 10 mg
   J9033          No Change       Inj., treanda 1 mg             Injection, bendamustine hcl (treanda), 1 mg
   J9034          No Change       Inj., bendeka 1 mg             Injection, bendamustine hcl (bendeka), 1 mg
   J9035          No Change       Bevacizumab injection          Injection, bevacizumab, 10 mg
   J9039          No Change       Injection, blinatumomab        Injection, blinatumomab, 1 microgram
   J9040          No Change       Bleomycin sulfate injection    Injection, bleomycin sulfate, 15 units
   J9042          No Change       Brentuximab vedotin inj        Injection, brentuximab vedotin, 1 mg
   J9043          No Change       Cabazitaxel injection          Injection, cabazitaxel, 1 mg
   J9045          No Change       Carboplatin injection          Injection, carboplatin, 50 mg
   J9047          No Change       Injection, carfilzomib, 1 mg   Injection, carfilzomib, 1 mg
   J9050          No Change       Carmustine injection           Injection, carmustine, 100 mg
   J9055          No Change       Cetuximab injection            Injection, cetuximab, 10 mg
   J9060          No Change       Cisplatin 10 mg injection      Injection, cisplatin, powder or solution, 10 mg
   J9065          No Change       Inj cladribine per 1 mg        Injection, cladribine, per 1 mg
   J9070          No Change       Cyclophosphamide 100 mg inj    Cyclophosphamide, 100 mg
   J9098          No Change       Cytarabine liposome inj        Injection, cytarabine liposome, 10 mg
   J9100          No Change       Cytarabine hcl 100 mg inj      Injection, cytarabine, 100 mg
   J9120          No Change       Dactinomycin injection         Injection, dactinomycin, 0.5 mg
   J9130          No Change       Dacarbazine 100 mg inj         Dacarbazine, 100 mg
   J9145          No Change       Injection, daratumumab 10 mg   Injection, daratumumab, 10 mg
   J9150          No Change       Daunorubicin injection         Injection, daunorubicin, 10 mg
   J9155          No Change       Degarelix injection            Injection, degarelix, 1 mg
   J9160          No Change       Denileukin diftitox inj        Injection, denileukin diftitox, 300 micrograms
   J9165          No Change       Diethylstilbestrol injection   Injection, diethylstilbestrol diphosphate, 250 mg
   J9171          No Change       Docetaxel injection            Injection, docetaxel, 1 mg
   J9175          No Change       Elliotts b solution per ml     Injection, elliotts' b solution, 1 ml
   J9176          No Change       Injection, elotuzumab, 1mg     Injection, elotuzumab, 1 mg
   J9178          No Change       Inj, epirubicin hcl, 2 mg      Injection, epirubicin hcl, 2 mg
   J9179          No Change       Eribulin mesylate injection    Injection, eribulin mesylate, 0.1 mg
   J9181          No Change       Etoposide injection            Injection, etoposide, 10 mg
   J9190          No Change       Fluorouracil injection         Injection, fluorouracil, 500 mg
   J9200          No Change       Floxuridine injection          Injection, floxuridine, 500 mg
   J9201          No Change       Gemcitabine hcl injection      Injection, gemcitabine hydrochloride, 200 mg
   J9202          No Change       Goserelin acetate implant      Goserelin acetate implant, per 3.6 mg
   J9203          No Change       Gemtuzumab ozogamicin 0.1 mg   Injection, gemtuzumab ozogamicin, 0.1 mg
   J9205          No Change       Inj irinotecan liposome 1 mg   Injection, irinotecan liposome, 1 mg
   J9206          No Change       Irinotecan injection           Injection, irinotecan, 20 mg
   J9207          No Change       Ixabepilone injection          Injection, ixabepilone, 1 mg
   J9208          No Change       Ifosfamide injection           Injection, ifosfamide, 1 gram
   J9209          No Change       Mesna injection                Injection, mesna, 200 mg
   J9212          No Change       Interferon alfacon-1 inj       Injection, interferon alfacon-1, recombinant, 1 microgram
   J9214          No Change       Interferon alfa-2b inj         Injection, interferon, alfa-2b, recombinant, 1 million units
   J9215          No Change       Interferon alfa-n3 inj         Injection, interferon, alfa-n3, (human leukocyte derived), 25
   J9217          No Change       Leuprolide acetate suspnsion   Leuprolide acetate (for depot suspension), 7.5 mg
   J9219          No Change       Leuprolide acetate implant     Leuprolide acetate implant, 65 mg
   J9225          No Change       Vantas implant                 Histrelin implant (vantas), 50 mg
   J9226          No Change       Supprelin la implant           Histrelin implant (supprelin la), 50 mg
   J9228          No Change       Ipilimumab injection           Injection, ipilimumab, 1 mg
   J9230          No Change       Mechlorethamine hcl inj        Injection, mechlorethamine hydrochloride, (nitrogen mustard),
   J9245          No Change       Inj melphalan hydrochl 50 mg   Injection, melphalan hydrochloride, 50 mg
   J9250          No Change       Methotrexate sodium inj        Methotrexate sodium, 5 mg
   J9260          No Change       Methotrexate sodium inj        Methotrexate sodium, 50 mg
   J9261          No Change       Nelarabine injection           Injection, nelarabine, 50 mg
   J9262          No Change       Inj, omacetaxine mep, 0.01mg   Injection, omacetaxine mepesuccinate, 0.01 mg
   J9263          No Change       Oxaliplatin                    Injection, oxaliplatin, 0.5 mg
   J9264          No Change       Paclitaxel protein bound       Injection, paclitaxel protein-bound particles, 1 mg
   J9265          No Change       Paclitaxel injection           Injection, paclitaxel, 30 mg
   J9266          No Change       Pegaspargase injection         Injection, pegaspargase, per single dose vial
   J9267          No Change       Paclitaxel injection           Injection, paclitaxel, 1 mg
   J9268          No Change       Pentostatin injection          Injection, pentostatin, 10 mg
   J9271          No Change       Inj pembrolizumab              Injection, pembrolizumab, 1 mg
   J9280          No Change       Mitomycin injection            Injection, mitomycin, 5 mg
   J9285          No Change       Inj, olaratumab, 10 mg         Injection, olaratumab, 10 mg
   J9293          No Change       Mitoxantrone hydrochl / 5 mg   Injection, mitoxantrone hydrochloride, per 5 mg
   J9295          No Change       Injection, necitumumab, 1 mg   Injection, necitumumab, 1 mg
   J9299          No Change       Injection, nivolumab           Injection, nivolumab, 1 mg
   J9300          No Change       Gemtuzumab ozogamicin inj      Injection, gemtuzumab ozogamicin, 5 mg
   J9301          No Change       Obinutuzumab inj               Injection, obinutuzumab, 10 mg
   J9302          No Change       Ofatumumab injection           Injection, ofatumumab, 10 mg
   J9303          No Change       Panitumumab injection          Injection, panitumumab, 10 mg
   J9305          No Change       Pemetrexed injection           Injection, pemetrexed, 10 mg
   J9306          No Change       Injection, pertuzumab, 1 mg    Injection, pertuzumab, 1 mg
   J9307          No Change       Pralatrexate injection         Injection, pralatrexate, 1 mg
   J9308          No Change       Injection, ramucirumab         Injection, ramucirumab, 5 mg
   J9315          No Change       Romidepsin injection           Injection, romidepsin, 1 mg
   J9320          No Change       Streptozocin injection         Injection, streptozocin, 1 gram
   J9325          No Change       Inj talimogene laherparepvec   Injection, talimogene laherparepvec, per 1 million plaque for
   J9328          No Change       Temozolomide injection         Injection, temozolomide, 1 mg
   J9330          No Change       Temsirolimus injection         Injection, temsirolimus, 1 mg
   J9340          No Change       Thiotepa injection             Injection, thiotepa, 15 mg
   J9351          No Change       Topotecan injection            Injection, topotecan, 0.1 mg
   J9352          No Change       Injection trabectedin 0.1mg    Injection, trabectedin, 0.1 mg
   J9354          No Change       Inj, ado-trastuzumab emt 1mg   Injection, ado-trastuzumab emtansine, 1 mg
   J9355          No Change       Trastuzumab injection          Injection, trastuzumab, 10 mg
   J9357          No Change       Valrubicin injection           Injection, valrubicin, intravesical, 200 mg
   J9360          No Change       Vinblastine sulfate inj        Injection, vinblastine sulfate, 1 mg
   J9370          No Change       Vincristine sulfate 1 mg inj   Vincristine sulfate, 1 mg
   J9371          No Change       Inj, vincristine sul lip 1mg   Injection, vincristine sulfate liposome, 1 mg
   J9390          No Change       Vinorelbine tartrate inj       Injection, vinorelbine tartrate, 10 mg
   J9395          No Change       Injection, fulvestrant         Injection, fulvestrant, 25 mg
   J9400          No Change       Inj, ziv-aflibercept, 1mg      Injection, ziv-aflibercept, 1 mg
   J9600          No Change       Porfimer sodium injection      Injection, porfimer sodium, 75 mg
   J9999          No Change       Chemotherapy drug              Not otherwise classified, antineoplastic drugs
   K0001          No Change       Standard wheelchair            Standard wheelchair
   K0002          No Change       Stnd hemi (low seat) whlchr    Standard hemi (low seat) wheelchair
   K0003          No Change       Lightweight wheelchair         Lightweight wheelchair
   K0004          No Change       High strength ltwt whlchr      High strength, lightweight wheelchair
   K0005          No Change       Ultralightweight wheelchair    Ultralightweight wheelchair
   K0006          No Change       Heavy duty wheelchair          Heavy duty wheelchair
   K0007          No Change       Extra heavy duty wheelchair    Extra heavy duty wheelchair
   K0008          No Change       Cstm manual wheelchair/base    Custom manual wheelchair/base
   K0009          No Change       Other manual wheelchair/base   Other manual wheelchair/base
   K0010          No Change       Stnd wt frame power whlchr     Standard - weight frame motorized/power wheelchair
   K0011          No Change       Stnd wt pwr whlchr w control   Standard - weight frame motorized/power wheelchair with progr
   K0012          No Change       Ltwt portbl power whlchr       Lightweight portable motorized/power wheelchair
   K0013          No Change       Custom power whlchr base       Custom motorized/power wheelchair base
   K0014          No Change       Other power whlchr base        Other motorized/power wheelchair base
   K0015          No Change       Detach non-adj ht armrst rep   Detachable, non-adjustable height armrest, replacement only,
   K0017          No Change       Detach adjust armrest base     Detachable, adjustable height armrest, base, replacement only
   K0018          No Change       Detach adjust armrst upper     Detachable, adjustable height armrest, upper portion, replace
   K0019          No Change       Arm pad repl, each             Arm pad, replacement only, each
   K0020          No Change       Fixed adjust armrest pair      Fixed, adjustable height armrest, pair
   K0038          No Change       Leg strap each                 Leg strap, each
   K0039          No Change       Leg strap h style each         Leg strap, h style, each
   K0040          No Change       Adjustable angle footplate     Adjustable angle footplate, each
   K0041          No Change       Large size footplate each      Large size footplate, each
   K0042          No Change       Standard size ftplate rep ea   Standard size footplate, replacement only, each
   K0043          No Change       Ftrst lowr exten tube rep ea   Footrest, lower extension tube, replacement only, each
   K0044          No Change       Ftrst upr hanger brac rep ea   Footrest, upper hanger bracket, replacement only, each
   K0045          No Change       Ftrst compl assembly repl ea   Footrest, complete assembly, replacement only, each
   K0046          No Change       Elev lgrst lwr exten repl ea   Elevating legrest, lower extension tube, replacement only, ea
   K0047          No Change       Elev legrst upr hangr rep ea   Elevating legrest, upper hanger bracket, replacement only, ea
   K0050          No Change       Ratchet assembly replacement   Ratchet assembly, replacement only
   K0051          No Change       Cam rel asm ft/legrst rep ea   Cam release assembly, footrest or legrest, replacement only,
   K0052          No Change       Swingaway detach ftrest repl   Swingaway, detachable footrests, replacement only, each
   K0053          No Change       Elevate footrest articulate    Elevating footrests, articulating (telescoping), each
   K0056          No Change       Seat ht <17 or >=21 ltwt wc    Seat height less than 17" or equal to or greater than 21" for
   K0065          No Change       Spoke protectors               Spoke protectors, each
   K0069          No Change       Rr whl compl sol tire rep ea   Rear wheel assembly, complete, with solid tire, spokes or mol
   K0070          No Change       Rr whl compl pne tire rep ea   Rear wheel assembly, complete, with pneumatic tire, spokes or
   K0071          No Change       Fr cstr comp pne tire rep ea   Front caster assembly, complete, with pneumatic tire, replace
   K0072          No Change       Fr cstr semi-pne tire rep ea   Front caster assembly, complete, with semi-pneumatic tire, re
   K0073          No Change       Caster pin lock each           Caster pin lock, each
   K0077          No Change       Fr cstr asmb sol tire rep ea   Front caster assembly, complete, with solid tire, replacement
   K0098          No Change       Drive belt for pwc, repl       Drive belt for power wheelchair, replacement only
   K0105          No Change       Iv hanger                      Iv hanger, each
   K0108          No Change       W/c component-accessory nos    Wheelchair component or accessory, not otherwise specified
   K0195          No Change       Elevating whlchair leg rests   Elevating leg rests, pair (for use with capped rental wheelch
   K0455          No Change       Pump uninterrupted infusion    Infusion pump used for uninterrupted parenteral administratio
   K0462          No Change       Temporary replacement eqpmnt   Temporary replacement for patient owned equipment being repai
   K0552          No Change       Sup/ext non-ins inf pump syr   Supplies for external non-insulin drug infusion pump, syringe
   K0553          No Change       Ther cgm supply allowance      Supply allowance for therapeutic continuous glucose monitor (
   K0554          No Change       Ther cgm receiver/monitor      Receiver (monitor), dedicated, for use with therapeutic gluco
   K0601          No Change       Repl batt silver oxide 1.5 v   Replacement battery for external infusion pump owned by patie
   K0602          No Change       Repl batt silver oxide 3 v     Replacement battery for external infusion pump owned by patie
   K0603          No Change       Repl batt alkaline 1.5 v       Replacement battery for external infusion pump owned by patie
   K0604          No Change       Repl batt lithium 3.6 v        Replacement battery for external infusion pump owned by patie
   K0605          No Change       Repl batt lithium 4.5 v        Replacement battery for external infusion pump owned by patie
   K0606          No Change       Aed garment w elec analysis    Automatic external defibrillator, with integrated electrocard
   K0607          No Change       Repl batt for aed              Replacement battery for automated external defibrillator, gar
   K0608          No Change       Repl garment for aed           Replacement garment for use with automated external defibrill
   K0609          No Change       Repl electrode for aed         Replacement electrodes for use with automated external defibr
   K0669          No Change       Seat/back cus no dmepdac ver   Wheelchair accessory, wheelchair seat or back cushion, does n
   K0672          No Change       Removable soft interface le    Addition to lower extremity orthosis, removable soft interfac
   K0730          No Change       Ctrl dose inh drug deliv sys   Controlled dose inhalation drug delivery system
   K0733          No Change       12-24hr sealed lead acid       Power wheelchair accessory, 12 to 24 amp hour sealed lead aci
   K0738          No Change       Portable gas oxygen system     Portable gaseous oxygen system, rental; home compressor used
   K0739          No Change       Repair/svc dme non-oxygen eq   Repair or nonroutine service for durable medical equipment ot
   K0740          No Change       Repair/svc oxygen equipment    Repair or nonroutine service for oxygen equipment requiring t
   K0743          No Change       Portable home suction pump     Suction pump, home model, portable, for use on wounds
   K0744          No Change       Absorp drg <= 16 suc pump      Absorptive wound dressing for use with suction pump, home mod
   K0745          No Change       Absorp drg >16<=48 suc pump    Absorptive wound dressing for use with suction pump, home mod
   K0746          No Change       Absorp drg >48 suc pump        Absorptive wound dressing for use with suction pump, home mod
   K0800          No Change       Pov group 1 std up to 300lbs   Power operated vehicle, group 1 standard, patient weight capa
   K0801          No Change       Pov group 1 hd 301-450 lbs     Power operated vehicle, group 1 heavy duty, patient weight ca
   K0802          No Change       Pov group 1 vhd 451-600 lbs    Power operated vehicle, group 1 very heavy duty, patient weig
   K0806          No Change       Pov group 2 std up to 300lbs   Power operated vehicle, group 2 standard, patient weight capa
   K0807          No Change       Pov group 2 hd 301-450 lbs     Power operated vehicle, group 2 heavy duty, patient weight ca
   K0808          No Change       Pov group 2 vhd 451-600 lbs    Power operated vehicle, group 2 very heavy duty, patient weig
   K0812          No Change       Power operated vehicle noc     Power operated vehicle, not otherwise classified
   K0813          No Change       Pwc gp 1 std port seat/back    Power wheelchair, group 1 standard, portable, sling/solid sea
   K0814          No Change       Pwc gp 1 std port cap chair    Power wheelchair, group 1 standard, portable, captains chair,
   K0815          No Change       Pwc gp 1 std seat/back         Power wheelchair, group 1 standard, sling/solid seat and back
   K0816          No Change       Pwc gp 1 std cap chair         Power wheelchair, group 1 standard, captains chair, patient w
   K0820          No Change       Pwc gp 2 std port seat/back    Power wheelchair, group 2 standard, portable, sling/solid sea
   K0821          No Change       Pwc gp 2 std port cap chair    Power wheelchair, group 2 standard, portable, captains chair,
   K0822          No Change       Pwc gp 2 std seat/back         Power wheelchair, group 2 standard, sling/solid seat/back, pa
   K0823          No Change       Pwc gp 2 std cap chair         Power wheelchair, group 2 standard, captains chair, patient w
   K0824          No Change       Pwc gp 2 hd seat/back          Power wheelchair, group 2 heavy duty, sling/solid seat/back,
   K0825          No Change       Pwc gp 2 hd cap chair          Power wheelchair, group 2 heavy duty, captains chair, patient
   K0826          No Change       Pwc gp 2 vhd seat/back         Power wheelchair, group 2 very heavy duty, sling/solid seat/b
   K0827          No Change       Pwc gp vhd cap chair           Power wheelchair, group 2 very heavy duty, captains chair, pa
   K0828          No Change       Pwc gp 2 xtra hd seat/back     Power wheelchair, group 2 extra heavy duty, sling/solid seat/
   K0829          No Change       Pwc gp 2 xtra hd cap chair     Power wheelchair, group 2 extra heavy duty, captains chair, p
   K0830          No Change       Pwc gp2 std seat elevate s/b   Power wheelchair, group 2 standard, seat elevator, sling/soli
   K0831          No Change       Pwc gp2 std seat elevate cap   Power wheelchair, group 2 standard, seat elevator, captains c
   K0835          No Change       Pwc gp2 std sing pow opt s/b   Power wheelchair, group 2 standard, single power option, slin
   K0836          No Change       Pwc gp2 std sing pow opt cap   Power wheelchair, group 2 standard, single power option, capt
   K0837          No Change       Pwc gp 2 hd sing pow opt s/b   Power wheelchair, group 2 heavy duty, single power option, sl
   K0838          No Change       Pwc gp 2 hd sing pow opt cap   Power wheelchair, group 2 heavy duty, single power option, ca
   K0839          No Change       Pwc gp2 vhd sing pow opt s/b   Power wheelchair, group 2 very heavy duty, single power optio
   K0840          No Change       Pwc gp2 xhd sing pow opt s/b   Power wheelchair, group 2 extra heavy duty, single power opti
   K0841          No Change       Pwc gp2 std mult pow opt s/b   Power wheelchair, group 2 standard, multiple power option, sl
   K0842          No Change       Pwc gp2 std mult pow opt cap   Power wheelchair, group 2 standard, multiple power option, ca
   K0843          No Change       Pwc gp2 hd mult pow opt s/b    Power wheelchair, group 2 heavy duty, multiple power option,
   K0848          No Change       Pwc gp 3 std seat/back         Power wheelchair, group 3 standard, sling/solid seat/back, pa
   K0849          No Change       Pwc gp 3 std cap chair         Power wheelchair, group 3 standard, captains chair, patient w
   K0850          No Change       Pwc gp 3 hd seat/back          Power wheelchair, group 3 heavy duty, sling/solid seat/back,
   K0851          No Change       Pwc gp 3 hd cap chair          Power wheelchair, group 3 heavy duty, captains chair, patient
   K0852          No Change       Pwc gp 3 vhd seat/back         Power wheelchair, group 3 very heavy duty, sling/solid seat/b
   K0853          No Change       Pwc gp 3 vhd cap chair         Power wheelchair, group 3 very heavy duty, captains chair, pa
   K0854          No Change       Pwc gp 3 xhd seat/back         Power wheelchair, group 3 extra heavy duty, sling/solid seat/
   K0855          No Change       Pwc gp 3 xhd cap chair         Power wheelchair, group 3 extra heavy duty, captains chair, p
   K0856          No Change       Pwc gp3 std sing pow opt s/b   Power wheelchair, group 3 standard, single power option, slin
   K0857          No Change       Pwc gp3 std sing pow opt cap   Power wheelchair, group 3 standard, single power option, capt
   K0858          No Change       Pwc gp3 hd sing pow opt s/b    Power wheelchair, group 3 heavy duty, single power option, sl
   K0859          No Change       Pwc gp3 hd sing pow opt cap    Power wheelchair, group 3 heavy duty, single power option, ca
   K0860          No Change       Pwc gp3 vhd sing pow opt s/b   Power wheelchair, group 3 very heavy duty, single power optio
   K0861          No Change       Pwc gp3 std mult pow opt s/b   Power wheelchair, group 3 standard, multiple power option, sl
   K0862          No Change       Pwc gp3 hd mult pow opt s/b    Power wheelchair, group 3 heavy duty, multiple power option,
   K0863          No Change       Pwc gp3 vhd mult pow opt s/b   Power wheelchair, group 3 very heavy duty, multiple power opt
   K0864          No Change       Pwc gp3 xhd mult pow opt s/b   Power wheelchair, group 3 extra heavy duty, multiple power op
   K0868          No Change       Pwc gp 4 std seat/back         Power wheelchair, group 4 standard, sling/solid seat/back, pa
   K0869          No Change       Pwc gp 4 std cap chair         Power wheelchair, group 4 standard, captains chair, patient w
   K0870          No Change       Pwc gp 4 hd seat/back          Power wheelchair, group 4 heavy duty, sling/solid seat/back,
   K0871          No Change       Pwc gp 4 vhd seat/back         Power wheelchair, group 4 very heavy duty, sling/solid seat/b
   K0877          No Change       Pwc gp4 std sing pow opt s/b   Power wheelchair, group 4 standard, single power option, slin
   K0878          No Change       Pwc gp4 std sing pow opt cap   Power wheelchair, group 4 standard, single power option, capt
   K0879          No Change       Pwc gp4 hd sing pow opt s/b    Power wheelchair, group 4 heavy duty, single power option, sl
   K0880          No Change       Pwc gp4 vhd sing pow opt s/b   Power wheelchair, group 4 very heavy duty, single power optio
   K0884          No Change       Pwc gp4 std mult pow opt s/b   Power wheelchair, group 4 standard, multiple power option, sl
   K0885          No Change       Pwc gp4 std mult pow opt cap   Power wheelchair, group 4 standard, multiple power option, ca
   K0886          No Change       Pwc gp4 hd mult pow s/b        Power wheelchair, group 4 heavy duty, multiple power option,
   K0890          No Change       Pwc gp5 ped sing pow opt s/b   Power wheelchair, group 5 pediatric, single power option, sli
   K0891          No Change       Pwc gp5 ped mult pow opt s/b   Power wheelchair, group 5 pediatric, multiple power option, s
   K0898          No Change       Power wheelchair noc           Power wheelchair, not otherwise classified
   K0899          No Change       Pow mobil dev no dmepdac       Power mobility device, not coded by dme pdac or does not meet
   K0900          No Change       Cstm dme other than wheelchr   Customized durable medical equipment, other than wheelchair
   K0901          No Change       Ko single upright pre ots      Knee orthosis (ko), single upright, thigh and calf, with adju
   K0902          No Change       Ko double upright pre ots      Knee orthosis (ko), double upright, thigh and calf, with adju
   L0112          No Change       Cranial cervical orthosis      Cranial cervical orthosis, congenital torticollis type, with
   L0113          No Change       Cranial cervical torticollis   Cranial cervical orthosis, torticollis type, with or without
   L0120          No Change       Cerv flex n/adj foam pre ots   Cervical, flexible, non-adjustable, prefabricated, off-the-sh
   L0130          No Change       Flex thermoplastic collar mo   Cervical, flexible, thermoplastic collar, molded to patient
   L0140          No Change       Cervical semi-rigid adjustab   Cervical, semi-rigid, adjustable (plastic collar)
   L0150          No Change       Cerv semi-rig adj molded chn   Cervical, semi-rigid, adjustable molded chin cup (plastic col
   L0160          No Change       Cerv sr wire occ/man pre ots   Cervical, semi-rigid, wire frame occipital/mandibular support
   L0170          No Change       Cervical collar molded to pt   Cervical, collar, molded to patient model
   L0172          No Change       Cerv col sr foam 2pc pre ots   Cervical, collar, semi-rigid thermoplastic foam, two-piece, p
   L0174          No Change       Cerv sr 2pc thor ext pre ots   Cervical, collar, semi-rigid, thermoplastic foam, two piece w
   L0180          No Change       Cer post col occ/man sup adj   Cervical, multiple post collar, occipital/mandibular supports
   L0190          No Change       Cerv collar supp adj cerv ba   Cervical, multiple post collar, occipital/mandibular supports
   L0200          No Change       Cerv col supp adj bar & thor   Cervical, multiple post collar, occipital/mandibular supports
   L0220          No Change       Thor rib belt custom fabrica   Thoracic, rib belt, custom fabricated
   L0450          No Change       Tlso flex trunk/thor pre ots   Tlso, flexible, provides trunk support, upper thoracic region
   L0452          No Change       Tlso flex custom fab thoraci   Tlso, flexible, provides trunk support, upper thoracic region
   L0454          No Change       Tlso trnk sj-t9 pre cst        Tlso flexible, provides trunk support, extends from sacrococc
   L0455          No Change       Tlso flex trnk sj-t9 pre ots   Tlso, flexible, provides trunk support, extends from sacrococ
   L0456          No Change       Tlso flex trnk sj-ss pre cst   Tlso, flexible, provides trunk support, thoracic region, rigi
   L0457          No Change       Tlso flex trnk sj-ss pre ots   Tlso, flexible, provides trunk support, thoracic region, rigi
   L0458          No Change       Tlso 2mod symphis-xipho pre    Tlso, triplanar control, modular segmented spinal system, two
   L0460          No Change       Tlso 2 shl symphys-stern cst   Tlso, triplanar control, modular segmented spinal system, two
   L0462          No Change       Tlso 3mod sacro-scap pre       Tlso, triplanar control, modular segmented spinal system, thr
   L0464          No Change       Tlso 4mod sacro-scap pre       Tlso, triplanar control, modular segmented spinal system, fou
   L0466          No Change       Tlso r fram soft ant pre cst   Tlso, sagittal control, rigid posterior frame and flexible so
   L0467          No Change       Tlso r fram soft pre ots       Tlso, sagittal control, rigid posterior frame and flexible so
   L0468          No Change       Tlso rig fram pelvic pre cst   Tlso, sagittal-coronal control, rigid posterior frame and fle
   L0469          No Change       Tlso rig fram pelvic pre ots   Tlso, sagittal-coronal control, rigid posterior frame and fle
   L0470          No Change       Tlso rigid frame pre subclav   Tlso, triplanar control, rigid posterior frame and flexible s
   L0472          No Change       Tlso rigid frame hyperex pre   Tlso, triplanar control, hyperextension, rigid anterior and l
   L0480          No Change       Tlso rigid plastic custom fa   Tlso, triplanar control, one piece rigid plastic shell withou
   L0482          No Change       Tlso rigid lined custom fab    Tlso, triplanar control, one piece rigid plastic shell with i
   L0484          No Change       Tlso rigid plastic cust fab    Tlso, triplanar control, two piece rigid plastic shell withou
   L0486          No Change       Tlso rigidlined cust fab two   Tlso, triplanar control, two piece rigid plastic shell with i
   L0488          No Change       Tlso rigid lined pre one pie   Tlso, triplanar control, one piece rigid plastic shell with i
   L0490          No Change       Tlso rigid plastic pre one     Tlso, sagittal-coronal control, one piece rigid plastic shell
   L0491          No Change       Tlso 2 piece rigid shell       Tlso, sagittal-coronal control, modular segmented spinal syst
   L0492          No Change       Tlso 3 piece rigid shell       Tlso, sagittal-coronal control, modular segmented spinal syst
   L0621          No Change       Sio flex pelvic/sacr pre ots   Sacroiliac orthosis, flexible, provides pelvic-sacral support
   L0622          No Change       Sio flex pelvisacral custom    Sacroiliac orthosis, flexible, provides pelvic-sacral support
   L0623          No Change       Sio rig pnl pelv/sac pre ots   Sacroiliac orthosis, provides pelvic-sacral support, with rig
   L0624          No Change       Sio panel custom               Sacroiliac orthosis, provides pelvic-sacral support, with rig
   L0625          No Change       Lo flex l1-below l5 pre ots    Lumbar orthosis, flexible, provides lumbar support, posterior
   L0626          No Change       Lo sag rig pnl stays pre cst   Lumbar orthosis, sagittal control, with rigid posterior panel
   L0627          No Change       Lo sag ri an/pos pnl pre cst   Lumbar orthosis, sagittal control, with rigid anterior and po
   L0628          No Change       Lso flex no ri stays pre ots   Lumbar-sacral orthosis, flexible, provides lumbo-sacral suppo
   L0629          No Change       Lso flex w/rigid stays cust    Lumbar-sacral orthosis, flexible, provides lumbo-sacral suppo
   L0630          No Change       Lso r post pnl sj-t9 pre cst   Lumbar-sacral orthosis, sagittal control, with rigid posterio
   L0631          No Change       Lso sag r an/pos pnl pre cst   Lumbar-sacral orthosis, sagittal control, with rigid anterior
   L0632          No Change       Lso sag rigid frame cust       Lumbar-sacral orthosis, sagittal control, with rigid anterior
   L0633          No Change       Lso sc r pos/lat pnl pre cst   Lumbar-sacral orthosis, sagittal-coronal control, with rigid
   L0634          No Change       Lso flexion control custom     Lumbar-sacral orthosis, sagittal-coronal control, with rigid
   L0635          No Change       Lso sagit rigid panel prefab   Lumbar-sacral orthosis, sagittal-coronal control, lumbar flex
   L0636          No Change       Lso sagittal rigid panel cus   Lumbar sacral orthosis, sagittal-coronal control, lumbar flex
   L0637          No Change       Lso sc r ant/pos pnl pre cst   Lumbar-sacral orthosis, sagittal-coronal control, with rigid
   L0638          No Change       Lso sag-coronal panel custom   Lumbar-sacral orthosis, sagittal-coronal control, with rigid
   L0639          No Change       Lso s/c shell/panel prefab     Lumbar-sacral orthosis, sagittal-coronal control, rigid shell
   L0640          No Change       Lso s/c shell/panel custom     Lumbar-sacral orthosis, sagittal-coronal control, rigid shell
   L0641          No Change       Lo rig pos pnl l1-l5 pre ots   Lumbar orthosis, sagittal control, with rigid posterior panel
   L0642          No Change       Lo sag ri an/pos pnl pre ots   Lumbar orthosis, sagittal control, with rigid anterior and po
   L0643          No Change       Lso sag ctr rigi pos pre ots   Lumbar-sacral orthosis, sagittal control, with rigid posterio
   L0648          No Change       Lso sag r an/pos pnl pre ots   Lumbar-sacral orthosis, sagittal control, with rigid anterior
   L0649          No Change       Lso sc r pos/lat pnl pre ots   Lumbar-sacral orthosis, sagittal-coronal control, with rigid
   L0650          No Change       Lso sc r ant/pos pnl pre ots   Lumbar-sacral orthosis, sagittal-coronal control, with rigid
   L0651          No Change       Lso sag-co shell pnl pre ots   Lumbar-sacral orthosis, sagittal-coronal control, rigid shell
   L0700          No Change       Ctlso a-p-l control molded     Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-po
   L0710          No Change       Ctlso a-p-l control w/ inter   Ctlso, anterior-posterior-lateral-control, molded to patient
   L0810          No Change       Halo cervical into jckt vest   Halo procedure, cervical halo incorporated into jacket vest
   L0820          No Change       Halo cervical into body jack   Halo procedure, cervical halo incorporated into plaster body
   L0830          No Change       Halo cerv into milwaukee typ   Halo procedure, cervical halo incorporated into milwaukee typ
   L0859          No Change       Mri compatible system          Addition to halo procedure, magnetic resonance image compatib
   L0861          No Change       Halo repl liner/interface      Addition to halo procedure, replacement liner/interface mater
   L0970          No Change       Tlso corset front              Tlso, corset front
   L0972          No Change       Lso corset front               Lso, corset front
   L0974          No Change       Tlso full corset               Tlso, full corset
   L0976          No Change       Lso full corset                Lso, full corset
   L0978          No Change       Axillary crutch extension      Axillary crutch extension
   L0980          No Change       Peroneal straps pair pre ots   Peroneal straps, prefabricated, off-the-shelf, pair
   L0982          No Change       Stocking sup grips 4 pre ots   Stocking supporter grips, prefabricated, off-the-shelf, set o
   L0984          No Change       Protect body sock ea pre ots   Protective body sock, prefabricated, off-the-shelf, each
   L0999          No Change       Add to spinal orthosis nos     Addition to spinal orthosis, not otherwise specified
   L1000          No Change       Ctlso milwauke initial model   Cervical-thoracic-lumbar-sacral orthosis (ctlso) (milwaukee),
   L1001          No Change       Ctlso infant immobilizer       Cervical thoracic lumbar sacral orthosis, immobilizer, infant
   L1005          No Change       Tension based scoliosis orth   Tension based scoliosis orthosis and accessory pads, includes
   L1010          No Change       Ctlso axilla sling             Addition to cervical-thoracic-lumbar-sacral orthosis (ctlso)
   L1020          No Change       Kyphosis pad                   Addition to ctlso or scoliosis orthosis, kyphosis pad
   L1025          No Change       Kyphosis pad floating          Addition to ctlso or scoliosis orthosis, kyphosis pad, floati
   L1030          No Change       Lumbar bolster pad             Addition to ctlso or scoliosis orthosis, lumbar bolster pad
   L1040          No Change       Lumbar or lumbar rib pad       Addition to ctlso or scoliosis orthosis, lumbar or lumbar rib
   L1050          No Change       Sternal pad                    Addition to ctlso or scoliosis orthosis, sternal pad
   L1060          No Change       Thoracic pad                   Addition to ctlso or scoliosis orthosis, thoracic pad
   L1070          No Change       Trapezius sling                Addition to ctlso or scoliosis orthosis, trapezius sling
   L1080          No Change       Outrigger                      Addition to ctlso or scoliosis orthosis, outrigger
   L1085          No Change       Outrigger bil w/ vert extens   Addition to ctlso or scoliosis orthosis, outrigger, bilateral
   L1090          No Change       Lumbar sling                   Addition to ctlso or scoliosis orthosis, lumbar sling
   L1100          No Change       Ring flange plastic/leather    Addition to ctlso or scoliosis orthosis, ring flange, plastic
   L1110          No Change       Ring flange plas/leather mol   Addition to ctlso or scoliosis orthosis, ring flange, plastic
   L1120          No Change       Covers for upright each        Addition to ctlso, scoliosis orthosis, cover for upright, eac
   L1200          No Change       Furnsh initial orthosis only   Thoracic-lumbar-sacral-orthosis (tlso), inclusive of furnishi
   L1210          No Change       Lateral thoracic extension     Addition to tlso, (low profile), lateral thoracic extension
   L1220          No Change       Anterior thoracic extension    Addition to tlso, (low profile), anterior thoracic extension
   L1230          No Change       Milwaukee type superstructur   Addition to tlso, (low profile), milwaukee type superstructur
   L1240          No Change       Lumbar derotation pad          Addition to tlso, (low profile), lumbar derotation pad
   L1250          No Change       Anterior asis pad              Addition to tlso, (low profile), anterior asis pad
   L1260          No Change       Anterior thoracic derotation   Addition to tlso, (low profile), anterior thoracic derotation
   L1270          No Change       Abdominal pad                  Addition to tlso, (low profile), abdominal pad
   L1280          No Change       Rib gusset (elastic) each      Addition to tlso, (low profile), rib gusset (elastic), each
   L1290          No Change       Lateral trochanteric pad       Addition to tlso, (low profile), lateral trochanteric pad
   L1300          No Change       Body jacket mold to patient    Other scoliosis procedure, body jacket molded to patient mode
   L1310          No Change       Post-operative body jacket     Other scoliosis procedure, post-operative body jacket
   L1499          No Change       Spinal orthosis nos            Spinal orthosis, not otherwise specified
   L1600          No Change       Ho flex frejka w/cov pre cst   Hip orthosis, abduction control of hip joints, flexible, frej
   L1610          No Change       Ho frejka cov only pre cst     Hip orthosis, abduction control of hip joints, flexible, (fre
   L1620          No Change       Ho flex pavlik harns pre cst   Hip orthosis, abduction control of hip joints, flexible, (pav
   L1630          No Change       Abduct control hip semi-flex   Hip orthosis, abduction control of hip joints, semi-flexible
   L1640          No Change       Pelv band/spread bar thigh c   Hip orthosis, abduction control of hip joints, static, pelvic
   L1650          No Change       Ho abduction hip adjustable    Hip orthosis, abduction control of hip joints, static, adjust
   L1652          No Change       Ho bi thighcuffs w sprdr bar   Hip orthosis, bilateral thigh cuffs with adjustable abductor
   L1660          No Change       Ho abduction static plastic    Hip orthosis, abduction control of hip joints, static, plasti
   L1680          No Change       Pelvic & hip control thigh c   Hip orthosis, abduction control of hip joints, dynamic, pelvi
   L1685          No Change       Post-op hip abduct custom fa   Hip orthosis, abduction control of hip joint, postoperative h
   L1686          No Change       Ho post-op hip abduction       Hip orthosis, abduction control of hip joint, postoperative h
   L1690          No Change       Combination bilateral ho       Combination, bilateral, lumbo-sacral, hip, femur orthosis pro
   L1700          No Change       Leg perthes orth toronto typ   Legg perthes orthosis, (toronto type), custom fabricated
   L1710          No Change       Legg perthes orth newington    Legg perthes orthosis, (newington type), custom fabricated
   L1720          No Change       Legg perthes orthosis trilat   Legg perthes orthosis, trilateral, (tachdijan type), custom f
   L1730          No Change       Legg perthes orth scottish r   Legg perthes orthosis, (scottish rite type), custom fabricate
   L1755          No Change       Legg perthes patten bottom t   Legg perthes orthosis, (patten bottom type), custom fabricate
   L1810          No Change       Ko elastic with joints         Knee orthosis, elastic with joints, prefabricated item that h
   L1812          No Change       Ko elastic w/joints pre ots    Knee orthosis, elastic with joints, prefabricated, off-the-sh
   L1820          No Change       Ko elas w/ condyle pads & jo   Knee orthosis, elastic with condylar pads and joints, with or
   L1830          No Change       Ko immob canvas long pre ots   Knee orthosis, immobilizer, canvas longitudinal, prefabricate
   L1831          No Change       Knee orth pos locking joint    Knee orthosis, locking knee joint(s), positional orthosis, pr
   L1832          No Change       Ko adj jnt pos r sup pre cst   Knee orthosis, adjustable knee joints (unicentric or polycent
   L1833          No Change       Ko adj jnt pos r sup pre ots   Knee orthosis, adjustable knee joints (unicentric or polycent
   L1834          No Change       Ko w/0 joint rigid molded to   Knee orthosis, without knee joint, rigid, custom fabricated
   L1836          No Change       Ko rigid w/o joints pre ots    Knee orthosis, rigid, without joint(s), includes soft interfa
   L1840          No Change       Ko derot ant cruciate custom   Knee orthosis, derotation, medial-lateral, anterior cruciate
   L1843          No Change       Ko single upright pre cst      Knee orthosis, single upright, thigh and calf, with adjustabl
   L1844          No Change       Ko w/adj jt rot cntrl molded   Knee orthosis, single upright, thigh and calf, with adjustabl
   L1845          No Change       Ko double upright pre cst      Knee orthosis, double upright, thigh and calf, with adjustabl
   L1846          No Change       Ko w adj flex/ext rotat mold   Knee orthosis, double upright, thigh and calf, with adjustabl
   L1847          No Change       Ko dbl upright w/air pre cst   Knee orthosis, double upright with adjustable joint, with inf
   L1848          No Change       Ko dbl upright w/air pre ots   Knee orthosis, double upright with adjustable joint, with inf
   L1850          No Change       Ko swedish type pre ots        Knee orthosis, swedish type, prefabricated, off-the-shelf
   L1851          No Change       Ko single upright prefab ots   Knee orthosis (ko), single upright, thigh and calf, with adju
   L1852          No Change       Ko double upright prefab ots   Knee orthosis (ko), double upright, thigh and calf, with adju
   L1860          No Change       Ko supracondylar socket mold   Knee orthosis, modification of supracondylar prosthetic socke
   L1900          No Change       Afo sprng wir drsflx calf bd   Ankle foot orthosis, spring wire, dorsiflexion assist calf ba
   L1902          No Change       Afo ankle gauntlet pre ots     Ankle orthosis, ankle gauntlet or similar, with or without jo
   L1904          No Change       Afo molded ankle gauntlet      Ankle orthosis, ankle gauntlet or similar, with or without jo
   L1906          No Change       Afo multilig ank sup pre ots   Ankle foot orthosis, multiligamentous ankle support, prefabri
   L1907          No Change       Afo supramalleolar custom      Ankle orthosis, supramalleolar with straps, with or without i
   L1910          No Change       Afo sing bar clasp attach sh   Ankle foot orthosis, posterior, single bar, clasp attachment
   L1920          No Change       Afo sing upright w/ adjust s   Ankle foot orthosis, single upright with static or adjustable
   L1930          No Change       Afo plastic                    Ankle foot orthosis, plastic or other material, prefabricated
   L1932          No Change       Afo rig ant tib prefab tcf/=   Afo, rigid anterior tibial section, total carbon fiber or equ
   L1940          No Change       Afo molded to patient plasti   Ankle foot orthosis, plastic or other material, custom fabric
   L1945          No Change       Afo molded plas rig ant tib    Ankle foot orthosis, plastic, rigid anterior tibial section (
   L1950          No Change       Afo spiral molded to pt plas   Ankle foot orthosis, spiral, (institute of rehabilitative med
   L1951          No Change       Afo spiral prefabricated       Ankle foot orthosis, spiral, (institute of rehabilitative med
   L1960          No Change       Afo pos solid ank plastic mo   Ankle foot orthosis, posterior solid ankle, plastic, custom f
   L1970          No Change       Afo plastic molded w/ankle j   Ankle foot orthosis, plastic with ankle joint, custom fabrica
   L1971          No Change       Afo w/ankle joint, prefab      Ankle foot orthosis, plastic or other material with ankle joi
   L1980          No Change       Afo sing solid stirrup calf    Ankle foot orthosis, single upright free plantar dorsiflexion
   L1990          No Change       Afo doub solid stirrup calf    Ankle foot orthosis, double upright free plantar dorsiflexion
   L2000          No Change       Kafo sing fre stirr thi/calf   Knee ankle foot orthosis, single upright, free knee, free ank
   L2005          No Change       Kafo sng/dbl mechanical act    Knee ankle foot orthosis, any material, single or double upri
   L2010          No Change       Kafo sng solid stirrup w/o j   Knee ankle foot orthosis, single upright, free ankle, solid s
   L2020          No Change       Kafo dbl solid stirrup band/   Knee ankle foot orthosis, double upright, free ankle, solid s
   L2030          No Change       Kafo dbl solid stirrup w/o j   Knee ankle foot orthosis, double upright, free ankle, solid s
   L2034          No Change       Kafo pla sin up w/wo k/a cus   Knee ankle foot orthosis, full plastic, single upright, with
   L2035          No Change       Kafo plastic pediatric size    Knee ankle foot orthosis, full plastic, static (pediatric siz
   L2036          No Change       Kafo plas doub free knee mol   Knee ankle foot orthosis, full plastic, double upright, with
   L2037          No Change       Kafo plas sing free knee mol   Knee ankle foot orthosis, full plastic, single upright, with
   L2038          No Change       Kafo w/o joint multi-axis an   Knee ankle foot orthosis, full plastic, with or without free
   L2040          No Change       Hkafo torsion bil rot straps   Hip knee ankle foot orthosis, torsion control, bilateral rota
   L2050          No Change       Hkafo torsion cable hip pelv   Hip knee ankle foot orthosis, torsion control, bilateral tors
   L2060          No Change       Hkafo torsion ball bearing j   Hip knee ankle foot orthosis, torsion control, bilateral tors
   L2070          No Change       Hkafo torsion unilat rot str   Hip knee ankle foot orthosis, torsion control, unilateral rot
   L2080          No Change       Hkafo unilat torsion cable     Hip knee ankle foot orthosis, torsion control, unilateral tor
   L2090          No Change       Hkafo unilat torsion ball br   Hip knee ankle foot orthosis, torsion control, unilateral tor
   L2106          No Change       Afo tib fx cast plaster mold   Ankle foot orthosis, fracture orthosis, tibial fracture cast
   L2108          No Change       Afo tib fx cast molded to pt   Ankle foot orthosis, fracture orthosis, tibial fracture cast
   L2112          No Change       Afo tibial fracture soft       Ankle foot orthosis, fracture orthosis, tibial fracture ortho
   L2114          No Change       Afo tib fx semi-rigid          Ankle foot orthosis, fracture orthosis, tibial fracture ortho
   L2116          No Change       Afo tibial fracture rigid      Ankle foot orthosis, fracture orthosis, tibial fracture ortho
   L2126          No Change       Kafo fem fx cast thermoplas    Knee ankle foot orthosis, fracture orthosis, femoral fracture
   L2128          No Change       Kafo fem fx cast molded to p   Knee ankle foot orthosis, fracture orthosis, femoral fracture
   L2132          No Change       Kafo femoral fx cast soft      Kafo, fracture orthosis, femoral fracture cast orthosis, soft
   L2134          No Change       Kafo fem fx cast semi-rigid    Kafo, fracture orthosis, femoral fracture cast orthosis, semi
   L2136          No Change       Kafo femoral fx cast rigid     Kafo, fracture orthosis, femoral fracture cast orthosis, rigi
   L2180          No Change       Plas shoe insert w ank joint   Addition to lower extremity fracture orthosis, plastic shoe i
   L2182          No Change       Drop lock knee                 Addition to lower extremity fracture orthosis, drop lock knee
   L2184          No Change       Limited motion knee joint      Addition to lower extremity fracture orthosis, limited motion
   L2186          No Change       Adj motion knee jnt lerman t   Addition to lower extremity fracture orthosis, adjustable mot
   L2188          No Change       Quadrilateral brim             Addition to lower extremity fracture orthosis, quadrilateral
   L2190          No Change       Waist belt                     Addition to lower extremity fracture orthosis, waist belt
   L2192          No Change       Pelvic band & belt thigh fla   Addition to lower extremity fracture orthosis, hip joint, pel
   L2200          No Change       Limited ankle motion ea jnt    Addition to lower extremity, limited ankle motion, each joint
   L2210          No Change       Dorsiflexion assist each joi   Addition to lower extremity, dorsiflexion assist (plantar fle
   L2220          No Change       Dorsi & plantar flex ass/res   Addition to lower extremity, dorsiflexion and plantar flexion
   L2230          No Change       Split flat caliper stirr & p   Addition to lower extremity, split flat caliper stirrups and
   L2232          No Change       Rocker bottom, contact afo     Addition to lower extremity orthosis, rocker bottom for total
   L2240          No Change       Round caliper and plate atta   Addition to lower extremity, round caliper and plate attachme
   L2250          No Change       Foot plate molded stirrup at   Addition to lower extremity, foot plate, molded to patient mo
   L2260          No Change       Reinforced solid stirrup       Addition to lower extremity, reinforced solid stirrup (scott-
   L2265          No Change       Long tongue stirrup            Addition to lower extremity, long tongue stirrup
   L2270          No Change       Varus/valgus strap padded/li   Addition to lower extremity, varus/valgus correction ('t') st
   L2275          No Change       Plastic mod low ext pad/line   Addition to lower extremity, varus/valgus correction, plastic
   L2280          No Change       Molded inner boot              Addition to lower extremity, molded inner boot
   L2300          No Change       Abduction bar jointed adjust   Addition to lower extremity, abduction bar (bilateral hip inv
   L2310          No Change       Abduction bar-straight         Addition to lower extremity, abduction bar-straight
   L2320          No Change       Non-molded lacer               Addition to lower extremity, non-molded lacer, for custom fab
   L2330          No Change       Lacer molded to patient mode   Addition to lower extremity, lacer molded to patient model, f
   L2335          No Change       Anterior swing band            Addition to lower extremity, anterior swing band
   L2340          No Change       Pre-tibial shell molded to p   Addition to lower extremity, pre-tibial shell, molded to pati
   L2350          No Change       Prosthetic type socket molde   Addition to lower extremity, prosthetic type, (bk) socket, mo
   L2360          No Change       Extended steel shank           Addition to lower extremity, extended steel shank
   L2370          No Change       Patten bottom                  Addition to lower extremity, patten bottom
   L2375          No Change       Torsion ank & half solid sti   Addition to lower extremity, torsion control, ankle joint and
   L2380          No Change       Torsion straight knee joint    Addition to lower extremity, torsion control, straight knee j
   L2385          No Change       Straight knee joint heavy du   Addition to lower extremity, straight knee joint, heavy duty,
   L2387          No Change       Add le poly knee custom kafo   Addition to lower extremity, polycentric knee joint, for cust
   L2390          No Change       Offset knee joint each         Addition to lower extremity, offset knee joint, each joint
   L2395          No Change       Offset knee joint heavy duty   Addition to lower extremity, offset knee joint, heavy duty, e
   L2397          No Change       Suspension sleeve lower ext    Addition to lower extremity orthosis, suspension sleeve
   L2405          No Change       Knee joint drop lock ea jnt    Addition to knee joint, drop lock, each
   L2415          No Change       Knee joint cam lock each joi   Addition to knee lock with integrated release mechanism (bail
   L2425          No Change       Knee disc/dial lock/adj flex   Addition to knee joint, disc or dial lock for adjustable knee
   L2430          No Change       Knee jnt ratchet lock ea jnt   Addition to knee joint, ratchet lock for active and progressi
   L2492          No Change       Knee lift loop drop lock rin   Addition to knee joint, lift loop for drop lock ring
   L2500          No Change       Thi/glut/ischia wgt bearing    Addition to lower extremity, thigh/weight bearing, gluteal/ i
   L2510          No Change       Th/wght bear quad-lat brim m   Addition to lower extremity, thigh/weight bearing, quadri- la
   L2520          No Change       Th/wght bear quad-lat brim c   Addition to lower extremity, thigh/weight bearing, quadri- la
   L2525          No Change       Th/wght bear nar m-l brim mo   Addition to lower extremity, thigh/weight bearing, ischial co
   L2526          No Change       Th/wght bear nar m-l brim cu   Addition to lower extremity, thigh/weight bearing, ischial co
   L2530          No Change       Thigh/wght bear lacer non-mo   Addition to lower extremity, thigh-weight bearing, lacer, non
   L2540          No Change       Thigh/wght bear lacer molded   Addition to lower extremity, thigh/weight bearing, lacer, mol
   L2550          No Change       Thigh/wght bear high roll cu   Addition to lower extremity, thigh/weight bearing, high roll
   L2570          No Change       Hip clevis type 2 posit jnt    Addition to lower extremity, pelvic control, hip joint, clevi
   L2580          No Change       Pelvic control pelvic sling    Addition to lower extremity, pelvic control, pelvic sling
   L2600          No Change       Hip clevis/thrust bearing fr   Addition to lower extremity, pelvic control, hip joint, clevi
   L2610          No Change       Hip clevis/thrust bearing lo   Addition to lower extremity, pelvic control, hip joint, clevi
   L2620          No Change       Pelvic control hip heavy dut   Addition to lower extremity, pelvic control, hip joint, heavy
   L2622          No Change       Hip joint adjustable flexion   Addition to lower extremity, pelvic control, hip joint, adjus
   L2624          No Change       Hip adj flex ext abduct cont   Addition to lower extremity, pelvic control, hip joint, adjus
   L2627          No Change       Plastic mold recipro hip & c   Addition to lower extremity, pelvic control, plastic, molded
   L2628          No Change       Metal frame recipro hip & ca   Addition to lower extremity, pelvic control, metal frame, rec
   L2630          No Change       Pelvic control band & belt u   Addition to lower extremity, pelvic control, band and belt, u
   L2640          No Change       Pelvic control band & belt b   Addition to lower extremity, pelvic control, band and belt, b
   L2650          No Change       Pelv & thor control gluteal    Addition to lower extremity, pelvic and thoracic control, glu
   L2660          No Change       Thoracic control thoracic ba   Addition to lower extremity, thoracic control, thoracic band
   L2670          No Change       Thorac cont paraspinal uprig   Addition to lower extremity, thoracic control, paraspinal upr
   L2680          No Change       Thorac cont lat support upri   Addition to lower extremity, thoracic control, lateral suppor
   L2750          No Change       Plating chrome/nickel pr bar   Addition to lower extremity orthosis, plating chrome or nicke
   L2755          No Change       Carbon graphite lamination     Addition to lower extremity orthosis, high strength, lightwei
   L2760          No Change       Extension per extension per    Addition to lower extremity orthosis, extension, per extensio
   L2768          No Change       Ortho sidebar disconnect       Orthotic side bar disconnect device, per bar
   L2780          No Change       Non-corrosive finish           Addition to lower extremity orthosis, non-corrosive finish, p
   L2785          No Change       Drop lock retainer each        Addition to lower extremity orthosis, drop lock retainer, eac
   L2795          No Change       Knee control full kneecap      Addition to lower extremity orthosis, knee control, full knee
   L2800          No Change       Knee cap medial or lateral p   Addition to lower extremity orthosis, knee control, knee cap,
   L2810          No Change       Knee control condylar pad      Addition to lower extremity orthosis, knee control, condylar
   L2820          No Change       Soft interface below knee se   Addition to lower extremity orthosis, soft interface for mold
   L2830          No Change       Soft interface above knee se   Addition to lower extremity orthosis, soft interface for mold
   L2840          No Change       Tibial length sock fx or equ   Addition to lower extremity orthosis, tibial length sock, fra
   L2850          No Change       Femoral lgth sock fx or equa   Addition to lower extremity orthosis, femoral length sock, fr
   L2861          No Change       Torsion mechanism knee/ankle   Addition to lower extremity joint, knee or ankle, concentric
   L2999          No Change       Lower extremity orthosis nos   Lower extremity orthoses, not otherwise specified
   L3000          No Change       Ft insert ucb berkeley shell   Foot, insert, removable, molded to patient model, 'ucb' type,
   L3001          No Change       Foot insert remov molded spe   Foot, insert, removable, molded to patient model, spenco, eac
   L3002          No Change       Foot insert plastazote or eq   Foot, insert, removable, molded to patient model, plastazote
   L3003          No Change       Foot insert silicone gel eac   Foot, insert, removable, molded to patient model, silicone ge
   L3010          No Change       Foot longitudinal arch suppo   Foot, insert, removable, molded to patient model, longitudina
   L3020          No Change       Foot longitud/metatarsal sup   Foot, insert, removable, molded to patient model, longitudina
   L3030          No Change       Foot arch support remov prem   Foot, insert, removable, formed to patient foot, each
   L3031          No Change       Foot lamin/prepreg composite   Foot, insert/plate, removable, addition to lower extremity or
   L3040          No Change       Ft arch suprt premold longit   Foot, arch support, removable, premolded, longitudinal, each
   L3050          No Change       Foot arch supp premold metat   Foot, arch support, removable, premolded, metatarsal, each
   L3060          No Change       Foot arch supp longitud/meta   Foot, arch support, removable, premolded, longitudinal/ metat
   L3070          No Change       Arch suprt att to sho longit   Foot, arch support, non-removable attached to shoe, longitudi
   L3080          No Change       Arch supp att to shoe metata   Foot, arch support, non-removable attached to shoe, metatarsa
   L3090          No Change       Arch supp att to shoe long/m   Foot, arch support, non-removable attached to shoe, longitudi
   L3100          No Change       Hallus-valgus nt dyn pre ots   Hallus-valgus night dynamic splint, prefabricated, off-the-sh
   L3140          No Change       Abduction rotation bar shoe    Foot, abduction rotation bar, including shoes
   L3150          No Change       Abduct rotation bar w/o shoe   Foot, abduction rotation bar, without shoes
   L3160          No Change       Shoe styled positioning dev    Foot, adjustable shoe-styled positioning device
   L3170          No Change       Foot plas heel stabi pre ots   Foot, plastic, silicone or equal, heel stabilizer, prefabrica
   L3201          No Change       Oxford w supinat/pronat inf    Orthopedic shoe, oxford with supinator or pronator, infant
   L3202          No Change       Oxford w/ supinat/pronator c   Orthopedic shoe, oxford with supinator or pronator, child
   L3203          No Change       Oxford w/ supinator/pronator   Orthopedic shoe, oxford with supinator or pronator, junior
   L3204          No Change       Hightop w/ supp/pronator inf   Orthopedic shoe, hightop with supinator or pronator, infant
   L3206          No Change       Hightop w/ supp/pronator chi   Orthopedic shoe, hightop with supinator or pronator, child
   L3207          No Change       Hightop w/ supp/pronator jun   Orthopedic shoe, hightop with supinator or pronator, junior
   L3208          No Change       Surgical boot each infant      Surgical boot, each, infant
   L3209          No Change       Surgical boot each child       Surgical boot, each, child
   L3211          No Change       Surgical boot each junior      Surgical boot, each, junior
   L3212          No Change       Benesch boot pair infant       Benesch boot, pair, infant
   L3213          No Change       Benesch boot pair child        Benesch boot, pair, child
   L3214          No Change       Benesch boot pair junior       Benesch boot, pair, junior
   L3215          No Change       Orthopedic ftwear ladies oxf   Orthopedic footwear, ladies shoe, oxford, each
   L3216          No Change       Orthoped ladies shoes dpth i   Orthopedic footwear, ladies shoe, depth inlay, each
   L3217          No Change       Ladies shoes hightop depth i   Orthopedic footwear, ladies shoe, hightop, depth inlay, each
   L3219          No Change       Orthopedic mens shoes oxford   Orthopedic footwear, mens shoe, oxford, each
   L3221          No Change       Orthopedic mens shoes dpth i   Orthopedic footwear, mens shoe, depth inlay, each
   L3222          No Change       Mens shoes hightop depth inl   Orthopedic footwear, mens shoe, hightop, depth inlay, each
   L3224          No Change       Woman's shoe oxford brace      Orthopedic footwear, woman's shoe, oxford, used as an integra
   L3225          No Change       Man's shoe oxford brace        Orthopedic footwear, man's shoe, oxford, used as an integral
   L3230          No Change       Custom shoes depth inlay       Orthopedic footwear, custom shoe, depth inlay, each
   L3250          No Change       Custom mold shoe remov prost   Orthopedic footwear, custom molded shoe, removable inner mold
   L3251          No Change       Shoe molded to pt silicone s   Foot, shoe molded to patient model, silicone shoe, each
   L3252          No Change       Shoe molded plastazote cust    Foot, shoe molded to patient model, plastazote (or similar),
   L3253          No Change       Shoe molded plastazote cust    Foot, molded shoe plastazote (or similar) custom fitted, each
   L3254          No Change       Orth foot non-stndard size/w   Non-standard size or width
   L3255          No Change       Orth foot non-standard size/   Non-standard size or length
   L3257          No Change       Orth foot add charge split s   Orthopedic footwear, additional charge for split size
   L3260          No Change       Ambulatory surgical boot eac   Surgical boot/shoe, each
   L3265          No Change       Plastazote sandal each         Plastazote sandal, each
   L3300          No Change       Sho lift taper to metatarsal   Lift, elevation, heel, tapered to metatarsals, per inch
   L3310          No Change       Shoe lift elev heel/sole neo   Lift, elevation, heel and sole, neoprene, per inch
   L3320          No Change       Shoe lift elev heel/sole cor   Lift, elevation, heel and sole, cork, per inch
   L3330          No Change       Lifts elevation metal extens   Lift, elevation, metal extension (skate)
   L3332          No Change       Shoe lifts tapered to one-ha   Lift, elevation, inside shoe, tapered, up to one-half inch
   L3334          No Change       Shoe lifts elevation heel /i   Lift, elevation, heel, per inch
   L3340          No Change       Shoe wedge sach                Heel wedge, sach
   L3350          No Change       Shoe heel wedge                Heel wedge
   L3360          No Change       Shoe sole wedge outside sole   Sole wedge, outside sole
   L3370          No Change       Shoe sole wedge between sole   Sole wedge, between sole
   L3380          No Change       Shoe clubfoot wedge            Clubfoot wedge
   L3390          No Change       Shoe outflare wedge            Outflare wedge
   L3400          No Change       Shoe metatarsal bar wedge ro   Metatarsal bar wedge, rocker
   L3410          No Change       Shoe metatarsal bar between    Metatarsal bar wedge, between sole
   L3420          No Change       Full sole/heel wedge btween    Full sole and heel wedge, between sole
   L3430          No Change       Sho heel count plast reinfor   Heel, counter, plastic reinforced
   L3440          No Change       Heel leather reinforced        Heel, counter, leather reinforced
   L3450          No Change       Shoe heel sach cushion type    Heel, sach cushion type
   L3455          No Change       Shoe heel new leather standa   Heel, new leather, standard
   L3460          No Change       Shoe heel new rubber standar   Heel, new rubber, standard
   L3465          No Change       Shoe heel thomas with wedge    Heel, thomas with wedge
   L3470          No Change       Shoe heel thomas extend to b   Heel, thomas extended to ball
   L3480          No Change       Shoe heel pad & depress for    Heel, pad and depression for spur
   L3485          No Change       Shoe heel pad removable for    Heel, pad, removable for spur
   L3500          No Change       Ortho shoe add leather insol   Orthopedic shoe addition, insole, leather
   L3510          No Change       Orthopedic shoe add rub insl   Orthopedic shoe addition, insole, rubber
   L3520          No Change       O shoe add felt w leath insl   Orthopedic shoe addition, insole, felt covered with leather
   L3530          No Change       Ortho shoe add half sole       Orthopedic shoe addition, sole, half
   L3540          No Change       Ortho shoe add full sole       Orthopedic shoe addition, sole, full
   L3550          No Change       O shoe add standard toe tap    Orthopedic shoe addition, toe tap standard
   L3560          No Change       O shoe add horseshoe toe tap   Orthopedic shoe addition, toe tap, horseshoe
   L3570          No Change       O shoe add instep extension    Orthopedic shoe addition, special extension to instep (leathe
   L3580          No Change       O shoe add instep velcro clo   Orthopedic shoe addition, convert instep to velcro closure
   L3590          No Change       O shoe convert to sof counte   Orthopedic shoe addition, convert firm shoe counter to soft c
   L3595          No Change       Ortho shoe add march bar       Orthopedic shoe addition, march bar
   L3600          No Change       Trans shoe calip plate exist   Transfer of an orthosis from one shoe to another, caliper pla
   L3610          No Change       Trans shoe caliper plate new   Transfer of an orthosis from one shoe to another, caliper pla
   L3620          No Change       Trans shoe solid stirrup exi   Transfer of an orthosis from one shoe to another, solid stirr
   L3630          No Change       Trans shoe solid stirrup new   Transfer of an orthosis from one shoe to another, solid stirr
   L3640          No Change       Shoe dennis browne splint bo   Transfer of an orthosis from one shoe to another, dennis brow
   L3649          No Change       Orthopedic shoe modifica nos   Orthopedic shoe, modification, addition or transfer, not othe
   L3650          No Change       So 8 abd restraint pre ots     Shoulder orthosis, figure of eight design abduction restraine
   L3660          No Change       So 8 ab rstr can/web pre ots   Shoulder orthosis, figure of eight design abduction restraine
   L3670          No Change       So acro/clav can web pre ots   Shoulder orthosis, acromio/clavicular (canvas and webbing typ
   L3671          No Change       So cap design w/o jnts cf      Shoulder orthosis, shoulder joint design, without joints, may
   L3674          No Change       So airplane w/wo joint cf      Shoulder orthosis, abduction positioning (airplane design), t
   L3675          No Change       So vest canvas/web pre ots     Shoulder orthosis, vest type abduction restrainer, canvas web
   L3677          No Change       So hard plas stabili pre cst   Shoulder orthosis, shoulder joint design, without joints, may
   L3678          No Change       So hard plas stabili pre ots   Shoulder orthosis, shoulder joint design, without joints, may
   L3702          No Change       Eo w/o joints cf               Elbow orthosis, without joints, may include soft interface, s
   L3710          No Change       Eo elas w/metal jnts pre ots   Elbow orthosis, elastic with metal joints, prefabricated, off
   L3720          No Change       Forearm/arm cuffs free motio   Elbow orthosis, double upright with forearm/arm cuffs, free m
   L3730          No Change       Forearm/arm cuffs ext/flex a   Elbow orthosis, double upright with forearm/arm cuffs, extens
   L3740          No Change       Cuffs adj lock w/ active con   Elbow orthosis, double upright with forearm/arm cuffs, adjust
   L3760          No Change       Eo adj jt prefab custom fit    Elbow orthosis (eo), with adjustable position locking joint(s
   L3761          No Change       Eo, adj lock joint prefab ot   Elbow orthosis (eo), with adjustable position locking joint(s
   L3762          No Change       Eo rigid w/o joints pre ots    Elbow orthosis, rigid, without joints, includes soft interfac
   L3763          No Change       Ewho rigid w/o jnts cf         Elbow wrist hand orthosis, rigid, without joints, may include
   L3764          No Change       Ewho w/joint(s) cf             Elbow wrist hand orthosis, includes one or more nontorsion jo
   L3765          No Change       Ewhfo rigid w/o jnts cf        Elbow wrist hand finger orthosis, rigid, without joints, may
   L3766          No Change       Ewhfo w/joint(s) cf            Elbow wrist hand finger orthosis, includes one or more nontor
   L3806          No Change       Whfo w/joint(s) custom fab     Wrist hand finger orthosis, includes one or more nontorsion j
   L3807          No Change       Whfo w/o joints pre cst        Wrist hand finger orthosis, without joint(s), prefabricated i
   L3808          No Change       Whfo, rigid w/o joints         Wrist hand finger orthosis, rigid without joints, may include
   L3809          No Change       Whfo w/o joints pre ots        Wrist hand finger orthosis, without joint(s), prefabricated,
   L3891          No Change       Torsion mechanism wrist/elbo   Addition to upper extremity joint, wrist or elbow, concentric
   L3900          No Change       Hinge extension/flex wrist/f   Wrist hand finger orthosis, dynamic flexor hinge, reciprocal
   L3901          No Change       Hinge ext/flex wrist finger    Wrist hand finger orthosis, dynamic flexor hinge, reciprocal
   L3904          No Change       Whfo electric custom fitted    Wrist hand finger orthosis, external powered, electric, custo
   L3905          No Change       Who w/nontorsion jnt(s) cf     Wrist hand orthosis, includes one or more nontorsion joints,
   L3906          No Change       Who w/o joints cf              Wrist hand orthosis, without joints, may include soft interfa
   L3908          No Change       Who cock-up nonmolde pre ots   Wrist hand orthosis, wrist extension control cock-up, non mol
   L3912          No Change       Hfo flexion glove pre ots      Hand finger orthosis (hfo), flexion glove with elastic finger
   L3913          No Change       Hfo w/o joints cf              Hand finger orthosis, without joints, may include soft interf
   L3915          No Change       Who nontorsion jnts pre cst    Wrist hand orthosis, includes one or more nontorsion joint(s)
   L3916          No Change       Who nontorsion jnts pre ots    Wrist hand orthosis, includes one or more nontorsion joint(s)
   L3917          No Change       Metacarp fx orthosis pre cst   Hand orthosis, metacarpal fracture orthosis, prefabricated it
   L3918          No Change       Metacarp fx orthosis pre ots   Hand orthosis, metacarpal fracture orthosis, prefabricated, o
   L3919          No Change       Ho w/o joints cf               Hand orthosis, without joints, may include soft interface, st
   L3921          No Change       Hfo w/joint(s) cf              Hand finger orthosis, includes one or more nontorsion joints,
   L3923          No Change       Hfo without joints pre cst     Hand finger orthosis, without joints, may include soft interf
   L3924          No Change       Hfo without joints pre ots     Hand finger orthosis, without joints, may include soft interf
   L3925          No Change       Fo pip dip jnt/sprng pre ots   Finger orthosis, proximal interphalangeal (pip)/distal interp
   L3927          No Change       Fo pip dip no jt spr pre ots   Finger orthosis, proximal interphalangeal (pip)/distal interp
   L3929          No Change       Hfo nontorsion jnts pre cst    Hand finger orthosis, includes one or more nontorsion joint(s
   L3930          No Change       Hfo nontorsion jnts pre ots    Hand finger orthosis, includes one or more nontorsion joint(s
   L3931          No Change       Whfo nontorsion joint prefab   Wrist hand finger orthosis, includes one or more nontorsion j
   L3933          No Change       Fo w/o joints cf               Finger orthosis, without joints, may include soft interface,
   L3935          No Change       Fo nontorsion joint cf         Finger orthosis, nontorsion joint, may include soft interface
   L3956          No Change       Add joint upper ext orthosis   Addition of joint to upper extremity orthosis, any material;
   L3960          No Change       Sewho airplan desig abdu pos   Shoulder elbow wrist hand orthosis, abduction positioning, ai
   L3961          No Change       Sewho cap design w/o jnts cf   Shoulder elbow wrist hand orthosis, shoulder cap design, with
   L3962          No Change       Sewho erbs palsey design abd   Shoulder elbow wrist hand orthosis, abduction positioning, er
   L3967          No Change       Sewho airplane w/o jnts cf     Shoulder elbow wrist hand orthosis, abduction positioning (ai
   L3971          No Change       Sewho cap design w/jnt(s) cf   Shoulder elbow wrist hand orthosis, shoulder cap design, incl
   L3973          No Change       Sewho airplane w/jnt(s) cf     Shoulder elbow wrist hand orthosis, abduction positioning (ai
   L3975          No Change       Sewhfo cap design w/o jnt cf   Shoulder elbow wrist hand finger orthosis, shoulder cap desig
   L3976          No Change       Sewhfo airplane w/o jnts cf    Shoulder elbow wrist hand finger orthosis, abduction position
   L3977          No Change       Sewhfo cap desgn w/jnt(s) cf   Shoulder elbow wrist hand finger orthosis, shoulder cap desig
   L3978          No Change       Sewhfo airplane w/jnt(s) cf    Shoulder elbow wrist hand finger orthosis, abduction position
   L3980          No Change       Up ext fx orthos humeral nos   Upper extremity fracture orthosis, humeral, prefabricated, in
   L3981          No Change       Ue fx orth shoul cap forearm   Upper extremity fracture orthosis, humeral, prefabricated, in
   L3982          No Change       Upper ext fx orthosis rad/ul   Upper extremity fracture orthosis, radius/ulnar, prefabricate
   L3984          No Change       Upper ext fx orthosis wrist    Upper extremity fracture orthosis, wrist, prefabricated, incl
   L3995          No Change       Sock fracture or equal each    Addition to upper extremity orthosis, sock, fracture or equal
   L3999          No Change       Upper limb orthosis nos        Upper limb orthosis, not otherwise specified
   L4000          No Change       Repl girdle milwaukee orth     Replace girdle for spinal orthosis (ctlso or so)
   L4002          No Change       Replace strap, any orthosis    Replacement strap, any orthosis, includes all components, any
   L4010          No Change       Replace trilateral socket br   Replace trilateral socket brim
   L4020          No Change       Replace quadlat socket brim    Replace quadrilateral socket brim, molded to patient model
   L4030          No Change       Replace socket brim cust fit   Replace quadrilateral socket brim, custom fitted
   L4040          No Change       Replace molded thigh lacer     Replace molded thigh lacer, for custom fabricated orthosis on
   L4045          No Change       Replace non-molded thigh lac   Replace non-molded thigh lacer, for custom fabricated orthosi
   L4050          No Change       Replace molded calf lacer      Replace molded calf lacer, for custom fabricated orthosis onl
   L4055          No Change       Replace non-molded calf lace   Replace non-molded calf lacer, for custom fabricated orthosis
   L4060          No Change       Replace high roll cuff         Replace high roll cuff
   L4070          No Change       Replace prox & dist upright    Replace proximal and distal upright for kafo
   L4080          No Change       Repl met band kafo-afo prox    Replace metal bands kafo, proximal thigh
   L4090          No Change       Repl met band kafo-afo calf/   Replace metal bands kafo-afo, calf or distal thigh
   L4100          No Change       Repl leath cuff kafo prox th   Replace leather cuff kafo, proximal thigh
   L4110          No Change       Repl leath cuff kafo-afo cal   Replace leather cuff kafo-afo, calf or distal thigh
   L4130          No Change       Replace pretibial shell        Replace pretibial shell
   L4205          No Change       Ortho dvc repair per 15 min    Repair of orthotic device, labor component, per 15 minutes
   L4210          No Change       Orth dev repair/repl minor p   Repair of orthotic device, repair or replace minor parts
   L4350          No Change       Ankle control ortho pre ots    Ankle control orthosis, stirrup style, rigid, includes any ty
   L4360          No Change       Pneumat walking boot pre cst   Walking boot, pneumatic and/or vacuum, with or without joints
   L4361          No Change       Pneuma/vac walk boot pre ots   Walking boot, pneumatic and/or vacuum, with or without joints
   L4370          No Change       Pneum full leg splnt pre ots   Pneumatic full leg splint, prefabricated, off-the-shelf
   L4386          No Change       Non-pneum walk boot pre cst    Walking boot, non-pneumatic, with or without joints, with or
   L4387          No Change       Non-pneum walk boot pre ots    Walking boot, non-pneumatic, with or without joints, with or
   L4392          No Change       Replace afo soft interface     Replacement, soft interface material, static afo
   L4394          No Change       Replace foot drop spint        Replace soft interface material, foot drop splint
   L4396          No Change       Static or dynami afo pre cst   Static or dynamic ankle foot orthosis, including soft interfa
   L4397          No Change       Static or dynami afo pre ots   Static or dynamic ankle foot orthosis, including soft interfa
   L4398          No Change       Foot drop splint pre ots       Foot drop splint, recumbent positioning device, prefabricated
   L4631          No Change       Afo, walk boot type, cus fab   Ankle foot orthosis, walking boot type, varus/valgus correcti
   L5000          No Change       Sho insert w arch toe filler   Partial foot, shoe insert with longitudinal arch, toe filler
   L5010          No Change       Mold socket ank hgt w/ toe f   Partial foot, molded socket, ankle height, with toe filler
   L5020          No Change       Tibial tubercle hgt w/ toe f   Partial foot, molded socket, tibial tubercle height, with toe
   L5050          No Change       Ank symes mold sckt sach ft    Ankle, symes, molded socket, sach foot
   L5060          No Change       Symes met fr leath socket ar   Ankle, symes, metal frame, molded leather socket, articulated
   L5100          No Change       Molded socket shin sach foot   Below knee, molded socket, shin, sach foot
   L5105          No Change       Plast socket jts/thgh lacer    Below knee, plastic socket, joints and thigh lacer, sach foot
   L5150          No Change       Mold sckt ext knee shin sach   Knee disarticulation (or through knee), molded socket, extern
   L5160          No Change       Mold socket bent knee shin s   Knee disarticulation (or through knee), molded socket, bent k
   L5200          No Change       Kne sing axis fric shin sach   Above knee, molded socket, single axis constant friction knee
   L5210          No Change       No knee/ankle joints w/ ft b   Above knee, short prosthesis, no knee joint ('stubbies'), wit
   L5220          No Change       No knee joint with artic ali   Above knee, short prosthesis, no knee joint ('stubbies'), wit
   L5230          No Change       Fem focal defic constant fri   Above knee, for proximal femoral focal deficiency, constant f
   L5250          No Change       Hip canad sing axi cons fric   Hip disarticulation, canadian type; molded socket, hip joint,
   L5270          No Change       Tilt table locking hip sing    Hip disarticulation, tilt table type; molded socket, locking
   L5280          No Change       Hemipelvect canad sing axis    Hemipelvectomy, canadian type; molded socket, hip joint, sing
   L5301          No Change       Bk mold socket sach ft endo    Below knee, molded socket, shin, sach foot, endoskeletal syst
   L5312          No Change       Knee disart, sach ft, endo     Knee disarticulation (or through knee), molded socket, single
   L5321          No Change       Ak open end sach               Above knee, molded socket, open end, sach foot, endoskeletal
   L5331          No Change       Hip disart canadian sach ft    Hip disarticulation, canadian type, molded socket, endoskelet
   L5341          No Change       Hemipelvectomy canadian sach   Hemipelvectomy, canadian type, molded socket, endoskeletal sy
   L5400          No Change       Postop dress & 1 cast chg bk   Immediate post surgical or early fitting, application of init
   L5410          No Change       Postop dsg bk ea add cast ch   Immediate post surgical or early fitting, application of init
   L5420          No Change       Postop dsg & 1 cast chg ak/d   Immediate post surgical or early fitting, application of init
   L5430          No Change       Postop dsg ak ea add cast ch   Immediate post surgical or early fitting, application of init
   L5450          No Change       Postop app non-wgt bear dsg    Immediate post surgical or early fitting, application of non-
   L5460          No Change       Postop app non-wgt bear dsg    Immediate post surgical or early fitting, application of non-
   L5500          No Change       Init bk ptb plaster direct     Initial, below knee 'ptb' type socket, non-alignable system,
   L5505          No Change       Init ak ischal plstr direct    Initial, above knee - knee disarticulation, ischial level soc
   L5510          No Change       Prep bk ptb plaster molded     Preparatory, below knee 'ptb' type socket, non-alignable syst
   L5520          No Change       Perp bk ptb thermopls direct   Preparatory, below knee 'ptb' type socket, non-alignable syst
   L5530          No Change       Prep bk ptb thermopls molded   Preparatory, below knee 'ptb' type socket, non-alignable syst
   L5535          No Change       Prep bk ptb open end socket    Preparatory, below knee 'ptb' type socket, non-alignable syst
   L5540          No Change       Prep bk ptb laminated socket   Preparatory, below knee 'ptb' type socket, non-alignable syst
   L5560          No Change       Prep ak ischial plast molded   Preparatory, above knee- knee disarticulation, ischial level
   L5570          No Change       Prep ak ischial direct form    Preparatory, above knee - knee disarticulation, ischial level
   L5580          No Change       Prep ak ischial thermo mold    Preparatory, above knee - knee disarticulation ischial level
   L5585          No Change       Prep ak ischial open end       Preparatory, above knee - knee disarticulation, ischial level
   L5590          No Change       Prep ak ischial laminated      Preparatory, above knee - knee disarticulation ischial level
   L5595          No Change       Hip disartic sach thermopls    Preparatory, hip disarticulation-hemipelvectomy, pylon, no co
   L5600          No Change       Hip disart sach laminat mold   Preparatory, hip disarticulation-hemipelvectomy, pylon, no co
   L5610          No Change       Above knee hydracadence        Addition to lower extremity, endoskeletal system, above knee,
   L5611          No Change       Ak 4 bar link w/fric swing     Addition to lower extremity, endoskeletal system, above knee
   L5613          No Change       Ak 4 bar ling w/hydraul swig   Addition to lower extremity, endoskeletal system, above knee-
   L5614          No Change       4-bar link above knee w/swng   Addition to lower extremity, exoskeletal system, above knee-k
   L5616          No Change       Ak univ multiplex sys frict    Addition to lower extremity, endoskeletal system, above knee,
   L5617          No Change       Ak/bk self-aligning unit ea    Addition to lower extremity, quick change self-aligning unit,
   L5618          No Change       Test socket symes              Addition to lower extremity, test socket, symes
   L5620          No Change       Test socket below knee         Addition to lower extremity, test socket, below knee
   L5622          No Change       Test socket knee disarticula   Addition to lower extremity, test socket, knee disarticulatio
   L5624          No Change       Test socket above knee         Addition to lower extremity, test socket, above knee
   L5626          No Change       Test socket hip disarticulat   Addition to lower extremity, test socket, hip disarticulation
   L5628          No Change       Test socket hemipelvectomy     Addition to lower extremity, test socket, hemipelvectomy
   L5629          No Change       Below knee acrylic socket      Addition to lower extremity, below knee, acrylic socket
   L5630          No Change       Syme typ expandabl wall sckt   Addition to lower extremity, symes type, expandable wall sock
   L5631          No Change       Ak/knee disartic acrylic soc   Addition to lower extremity, above knee or knee disarticulati
   L5632          No Change       Symes type ptb brim design s   Addition to lower extremity, symes type, 'ptb' brim design so
   L5634          No Change       Symes type poster opening so   Addition to lower extremity, symes type, posterior opening (c
   L5636          No Change       Symes type medial opening so   Addition to lower extremity, symes type, medial opening socke
   L5637          No Change       Below knee total contact       Addition to lower extremity, below knee, total contact
   L5638          No Change       Below knee leather socket      Addition to lower extremity, below knee, leather socket
   L5639          No Change       Below knee wood socket         Addition to lower extremity, below knee, wood socket
   L5640          No Change       Knee disarticulat leather so   Addition to lower extremity, knee disarticulation, leather so
   L5642          No Change       Above knee leather socket      Addition to lower extremity, above knee, leather socket
   L5643          No Change       Hip flex inner socket ext fr   Addition to lower extremity, hip disarticulation, flexible in
   L5644          No Change       Above knee wood socket         Addition to lower extremity, above knee, wood socket
   L5645          No Change       Bk flex inner socket ext fra   Addition to lower extremity, below knee, flexible inner socke
   L5646          No Change       Below knee cushion socket      Addition to lower extremity, below knee, air, fluid, gel or e
   L5647          No Change       Below knee suction socket      Addition to lower extremity, below knee suction socket
   L5648          No Change       Above knee cushion socket      Addition to lower extremity, above knee, air, fluid, gel or e
   L5649          No Change       Isch containmt/narrow m-l so   Addition to lower extremity, ischial containment/narrow m-l s
   L5650          No Change       Tot contact ak/knee disart s   Additions to lower extremity, total contact, above knee or kn
   L5651          No Change       Ak flex inner socket ext fra   Addition to lower extremity, above knee, flexible inner socke
   L5652          No Change       Suction susp ak/knee disart    Addition to lower extremity, suction suspension, above knee o
   L5653          No Change       Knee disart expand wall sock   Addition to lower extremity, knee disarticulation, expandable
   L5654          No Change       Socket insert symes            Addition to lower extremity, socket insert, symes, (kemblo, p
   L5655          No Change       Socket insert below knee       Addition to lower extremity, socket insert, below knee (kembl
   L5656          No Change       Socket insert knee articulat   Addition to lower extremity, socket insert, knee disarticulat
   L5658          No Change       Socket insert above knee       Addition to lower extremity, socket insert, above knee (kembl
   L5661          No Change       Multi-durometer symes          Addition to lower extremity, socket insert, multi-durometer s
   L5665          No Change       Multi-durometer below knee     Addition to lower extremity, socket insert, multi-durometer,
   L5666          No Change       Below knee cuff suspension     Addition to lower extremity, below knee, cuff suspension
   L5668          No Change       Bk molded distal cushion       Addition  to lower extremity, below knee, molded distal cushi
   L5670          No Change       Bk molded supracondylar susp   Addition to lower extremity, below knee, molded supracondylar
   L5671          No Change       Bk/ak locking mechanism        Addition to lower extremity, below knee / above knee suspensi
   L5672          No Change       Bk removable medial brim sus   Addition to lower extremity, below knee, removable medial bri
   L5673          No Change       Socket insert w lock mech      Addition to lower extremity, below knee/above knee, custom fa
   L5676          No Change       Bk knee joints single axis p   Additions to lower extremity, below knee, knee joints, single
   L5677          No Change       Bk knee joints polycentric p   Additions to lower extremity, below knee, knee joints, polyce
   L5678          No Change       Bk joint covers pair           Additions to lower extremity, below knee, joint covers, pair
   L5679          No Change       Socket insert w/o lock mech    Addition to lower extremity, below knee/above knee, custom fa
   L5680          No Change       Bk thigh lacer non-molded      Addition to lower extremity, below knee, thigh lacer, nonmold
   L5681          No Change       Intl custm cong/latyp insert   Addition to lower extremity, below knee/above knee, custom fa
   L5682          No Change       Bk thigh lacer glut/ischia m   Addition to lower extremity, below knee, thigh lacer, gluteal
   L5683          No Change       Initial custom socket insert   Addition to lower extremity, below knee/above knee, custom fa
   L5684          No Change       Bk fork strap                  Addition to lower extremity, below knee, fork strap
   L5685          No Change       Below knee sus/seal sleeve     Addition to lower extremity prosthesis, below knee, suspensio
   L5686          No Change       Bk back check                  Addition to lower extremity, below knee, back check (extensio
   L5688          No Change       Bk waist belt webbing          Addition to lower extremity, below knee, waist belt, webbing
   L5690          No Change       Bk waist belt padded and lin   Addition to lower extremity, below knee, waist belt, padded a
   L5692          No Change       Ak pelvic control belt light   Addition to lower extremity, above knee, pelvic control belt,
   L5694          No Change       Ak pelvic control belt pad/l   Addition to lower extremity, above knee, pelvic control belt,
   L5695          No Change       Ak sleeve susp neoprene/equa   Addition to lower extremity, above knee, pelvic control, slee
   L5696          No Change       Ak/knee disartic pelvic join   Addition to lower extremity, above knee or knee disarticulati
   L5697          No Change       Ak/knee disartic pelvic band   Addition to lower extremity, above knee or knee disarticulati
   L5698          No Change       Ak/knee disartic silesian ba   Addition to lower extremity, above knee or knee disarticulati
   L5699          No Change       Shoulder harness               All lower extremity prostheses, shoulder harness
   L5700          No Change       Replace socket below knee      Replacement, socket, below knee, molded to patient model
   L5701          No Change       Replace socket above knee      Replacement, socket, above knee/knee disarticulation, includi
   L5702          No Change       Replace socket hip             Replacement, socket, hip disarticulation, including hip joint
   L5703          No Change       Symes ankle w/o (sach) foot    Ankle, symes, molded to patient model, socket without solid a
   L5704          No Change       Custom shape cover bk          Custom shaped protective cover, below knee
   L5705          No Change       Custom shape cover ak          Custom shaped protective cover, above knee
   L5706          No Change       Custom shape cvr knee disart   Custom shaped protective cover, knee disarticulation
   L5707          No Change       Custom shape cvr hip disart    Custom shaped protective cover, hip disarticulation
   L5710          No Change       Kne-shin exo sng axi mnl loc   Addition, exoskeletal knee-shin system, single axis, manual l
   L5711          No Change       Knee-shin exo mnl lock ultra   Additions exoskeletal knee-shin system, single axis, manual l
   L5712          No Change       Knee-shin exo frict swg & st   Addition, exoskeletal knee-shin system, single axis, friction
   L5714          No Change       Knee-shin exo variable frict   Addition, exoskeletal knee-shin system, single axis, variable
   L5716          No Change       Knee-shin exo mech stance ph   Addition, exoskeletal knee-shin system, polycentric, mechanic
   L5718          No Change       Knee-shin exo frct swg & sta   Addition, exoskeletal knee-shin system, polycentric, friction
   L5722          No Change       Knee-shin pneum swg frct exo   Addition, exoskeletal knee-shin system, single axis, pneumati
   L5724          No Change       Knee-shin exo fluid swing ph   Addition, exoskeletal knee-shin system, single axis, fluid sw
   L5726          No Change       Knee-shin ext jnts fld swg e   Addition, exoskeletal knee-shin system, single axis, external
   L5728          No Change       Knee-shin fluid swg & stance   Addition, exoskeletal knee-shin system, single axis, fluid sw
   L5780          No Change       Knee-shin pneum/hydra pneum    Addition, exoskeletal knee-shin system, single axis, pneumati
   L5781          No Change       Lower limb pros vacuum pump    Addition to lower limb prosthesis, vacuum pump, residual limb
   L5782          No Change       Hd low limb pros vacuum pump   Addition to lower limb prosthesis, vacuum pump, residual limb
   L5785          No Change       Exoskeletal bk ultralt mater   Addition, exoskeletal system, below knee, ultra-light materia
   L5790          No Change       Exoskeletal ak ultra-light m   Addition, exoskeletal system, above knee, ultra-light materia
   L5795          No Change       Exoskel hip ultra-light mate   Addition, exoskeletal system, hip disarticulation, ultra-ligh
   L5810          No Change       Endoskel knee-shin mnl lock    Addition, endoskeletal knee-shin system, single axis, manual
   L5811          No Change       Endo knee-shin mnl lck ultra   Addition, endoskeletal knee-shin system, single axis, manual
   L5812          No Change       Endo knee-shin frct swg & st   Addition, endoskeletal knee-shin system, single axis, frictio
   L5814          No Change       Endo knee-shin hydral swg ph   Addition, endoskeletal knee-shin system, polycentric, hydraul
   L5816          No Change       Endo knee-shin polyc mch sta   Addition, endoskeletal knee-shin system, polycentric, mechani
   L5818          No Change       Endo knee-shin frct swg & st   Addition, endoskeletal knee-shin system, polycentric, frictio
   L5822          No Change       Endo knee-shin pneum swg frc   Addition, endoskeletal knee-shin system, single axis, pneumat
   L5824          No Change       Endo knee-shin fluid swing p   Addition, endoskeletal knee-shin system, single axis, fluid s
   L5826          No Change       Miniature knee joint           Addition, endoskeletal knee-shin system, single axis, hydraul
   L5828          No Change       Endo knee-shin fluid swg/sta   Addition, endoskeletal knee-shin system, single axis, fluid s
   L5830          No Change       Endo knee-shin pneum/swg pha   Addition, endoskeletal knee-shin system, single axis, pneumat
   L5840          No Change       Multi-axial knee/shin system   Addition, endoskeletal knee/shin system, 4-bar linkage or mul
   L5845          No Change       Knee-shin sys stance flexion   Addition, endoskeletal, knee-shin system, stance flexion feat
   L5848          No Change       Knee-shin sys hydraul stance   Addition to endoskeletal knee-shin system, fluid stance exten
   L5850          No Change       Endo ak/hip knee extens assi   Addition, endoskeletal system, above knee or hip disarticulat
   L5855          No Change       Mech hip extension assist      Addition, endoskeletal system, hip disarticulation, mechanica
   L5856          No Change       Elec knee-shin swing/stance    Addition to lower extremity prosthesis, endoskeletal knee-shi
   L5857          No Change       Elec knee-shin swing only      Addition to lower extremity prosthesis, endoskeletal knee-shi
   L5858          No Change       Stance phase only              Addition to lower extremity prosthesis, endoskeletal knee shi
   L5859          No Change       Knee-shin pro flex/ext cont    Addition to lower extremity prosthesis, endoskeletal knee-shi
   L5910          No Change       Endo below knee alignable sy   Addition, endoskeletal system, below knee, alignable system
   L5920          No Change       Endo ak/hip alignable system   Addition, endoskeletal system, above knee or hip disarticulat
   L5925          No Change       Above knee manual lock         Addition, endoskeletal system, above knee, knee disarticulati
   L5930          No Change       High activity knee frame       Addition, endoskeletal system, high activity knee control fra
   L5940          No Change       Endo bk ultra-light material   Addition, endoskeletal system, below knee, ultra-light materi
   L5950          No Change       Endo ak ultra-light material   Addition, endoskeletal system, above knee, ultra-light materi
   L5960          No Change       Endo hip ultra-light materia   Addition, endoskeletal system, hip disarticulation, ultra-lig
   L5961          No Change       Endo poly hip, pneu/hyd/rot    Addition, endoskeletal system, polycentric hip joint, pneumat
   L5962          No Change       Below knee flex cover system   Addition, endoskeletal system, below knee, flexible protectiv
   L5964          No Change       Above knee flex cover system   Addition, endoskeletal system, above knee, flexible protectiv
   L5966          No Change       Hip flexible cover system      Addition, endoskeletal system, hip disarticulation, flexible
   L5968          No Change       Multiaxial ankle w dorsiflex   Addition to lower limb prosthesis, multiaxial ankle with swin
   L5969          No Change       Ak/ft power asst incl motors   Addition, endoskeletal ankle-foot or ankle system, power assi
   L5970          No Change       Foot external keel sach foot   All lower extremity prostheses, foot, external keel, sach foo
   L5971          No Change       Sach foot, replacement         All lower extremity prosthesis, solid ankle cushion heel (sac
   L5972          No Change       Flexible keel foot             All lower extremity prostheses, foot, flexible keel
   L5973          No Change       Ank-foot sys dors-plant flex   Endoskeletal ankle foot system, microprocessor controlled fea
   L5974          No Change       Foot single axis ankle/foot    All lower extremity prostheses, foot, single axis ankle/foot
   L5975          No Change       Combo ankle/foot prosthesis    All lower extremity prosthesis, combination single axis ankle
   L5976          No Change       Energy storing foot            All lower extremity prostheses, energy storing foot (seattle
   L5978          No Change       Ft prosth multiaxial ankl/ft   All lower extremity prostheses, foot, multiaxial ankle/foot
   L5979          No Change       Multi-axial ankle/ft prosth    All lower extremity prosthesis, multi-axial ankle, dynamic re
   L5980          No Change       Flex foot system               All lower extremity prostheses, flex foot system
   L5981          No Change       Flex-walk sys low ext prosth   All lower extremity prostheses, flex-walk system or equal
   L5982          No Change       Exoskeletal axial rotation u   All exoskeletal lower extremity prostheses, axial rotation un
   L5984          No Change       Endoskeletal axial rotation    All endoskeletal lower extremity prosthesis, axial rotation u
   L5985          No Change       Lwr ext dynamic prosth pylon   All endoskeletal lower extremity prostheses, dynamic prosthet
   L5986          No Change       Multi-axial rotation unit      All lower extremity prostheses, multi-axial rotation unit ('m
   L5987          No Change       Shank ft w vert load pylon     All lower extremity prosthesis, shank foot system with vertic
   L5988          No Change       Vertical shock reducing pylo   Addition to lower limb prosthesis, vertical shock reducing py
   L5990          No Change       User adjustable heel height    Addition to lower extremity prosthesis, user adjustable heel
   L5999          No Change       Lowr extremity prosthes nos    Lower extremity prosthesis, not otherwise specified
   L6000          No Change       Part hand thumb rem            Partial hand, thumb remaining
   L6010          No Change       Part hand little/ring          Partial hand, little and/or ring finger remaining
   L6020          No Change       Part hand no fingers           Partial hand, no finger remaining
   L6025          No Change       Part hand disart myoelectric   Transcarpal/metacarpal or partial hand disarticulation prosth
   L6026          No Change       Part hand myo exclu term dev   Transcarpal/metacarpal or partial hand disarticulation prosth
   L6050          No Change       Wrst mld sck flx hng tri pad   Wrist disarticulation, molded socket, flexible elbow hinges,
   L6055          No Change       Wrst mold sock w/exp interfa   Wrist disarticulation, molded socket with expandable interfac
   L6100          No Change       Elb mold sock flex hinge pad   Below elbow, molded socket, flexible elbow hinge, triceps pad
   L6110          No Change       Elbow mold sock suspension t   Below elbow, molded socket, (muenster or northwestern suspens
   L6120          No Change       Elbow mold doub splt soc ste   Below elbow, molded double wall split socket, step-up hinges,
   L6130          No Change       Elbow stump activated lock h   Below elbow, molded double wall split socket, stump activated
   L6200          No Change       Elbow mold outsid lock hinge   Elbow disarticulation, molded socket, outside locking hinge,
   L6205          No Change       Elbow molded w/ expand inter   Elbow disarticulation, molded socket with expandable interfac
   L6250          No Change       Elbow inter loc elbow forarm   Above elbow, molded double wall socket, internal locking elbo
   L6300          No Change       Shlder disart int lock elbow   Shoulder disarticulation, molded socket, shoulder bulkhead, h
   L6310          No Change       Shoulder passive restor comp   Shoulder disarticulation, passive restoration (complete prost
   L6320          No Change       Shoulder passive restor cap    Shoulder disarticulation, passive restoration (shoulder cap o
   L6350          No Change       Thoracic intern lock elbow     Interscapular thoracic, molded socket, shoulder bulkhead, hum
   L6360          No Change       Thoracic passive restor comp   Interscapular thoracic, passive restoration (complete prosthe
   L6370          No Change       Thoracic passive restor cap    Interscapular thoracic, passive restoration (shoulder cap onl
   L6380          No Change       Postop dsg cast chg wrst/elb   Immediate post surgical or early fitting, application of init
   L6382          No Change       Postop dsg cast chg elb dis/   Immediate post surgical or early fitting, application of init
   L6384          No Change       Postop dsg cast chg shlder/t   Immediate post surgical or early fitting, application of init
   L6386          No Change       Postop ea cast chg & realign   Immediate post surgical or early fitting, each additional cas
   L6388          No Change       Postop applicat rigid dsg on   Immediate post surgical or early fitting, application of rigi
   L6400          No Change       Below elbow prosth tiss shap   Below elbow, molded socket, endoskeletal system, including so
   L6450          No Change       Elb disart prosth tiss shap    Elbow disarticulation, molded socket, endoskeletal system, in
   L6500          No Change       Above elbow prosth tiss shap   Above elbow, molded socket, endoskeletal system, including so
   L6550          No Change       Shldr disar prosth tiss shap   Shoulder disarticulation, molded socket, endoskeletal system,
   L6570          No Change       Scap thorac prosth tiss shap   Interscapular thoracic, molded socket, endoskeletal system, i
   L6580          No Change       Wrist/elbow bowden cable mol   Preparatory, wrist disarticulation or below elbow, single wal
   L6582          No Change       Wrist/elbow bowden cbl dir f   Preparatory, wrist disarticulation or below elbow, single wal
   L6584          No Change       Elbow fair lead cable molded   Preparatory, elbow disarticulation or above elbow, single wal
   L6586          No Change       Elbow fair lead cable dir fo   Preparatory, elbow disarticulation or above elbow, single wal
   L6588          No Change       Shdr fair lead cable molded    Preparatory, shoulder disarticulation or interscapular thorac
   L6590          No Change       Shdr fair lead cable direct    Preparatory, shoulder disarticulation or interscapular thorac
   L6600          No Change       Polycentric hinge pair         Upper extremity additions, polycentric hinge, pair
   L6605          No Change       Single pivot hinge pair        Upper extremity additions, single pivot hinge, pair
   L6610          No Change       Flexible metal hinge pair      Upper extremity additions, flexible metal hinge, pair
   L6611          No Change       Additional switch, ext power   Addition to upper extremity prosthesis, external powered, add
   L6615          No Change       Disconnect locking wrist uni   Upper extremity addition, disconnect locking wrist unit
   L6616          No Change       Disconnect insert locking wr   Upper extremity addition, additional disconnect insert for lo
   L6620          No Change       Flexion/extension wrist unit   Upper extremity addition, flexion/extension wrist unit, with
   L6621          No Change       Flex/ext wrist w/wo friction   Upper extremity prosthesis addition, flexion/extension wrist
   L6623          No Change       Spring-ass rot wrst w/ latch   Upper extremity addition, spring assisted rotational wrist un
   L6624          No Change       Flex/ext/rotation wrist unit   Upper extremity addition, flexion/extension and rotation wris
   L6625          No Change       Rotation wrst w/ cable lock    Upper extremity addition, rotation wrist unit with cable lock
   L6628          No Change       Quick disconn hook adapter o   Upper extremity addition, quick disconnect hook adapter, otto
   L6629          No Change       Lamination collar w/ couplin   Upper extremity addition, quick disconnect lamination collar
   L6630          No Change       Stainless steel any wrist      Upper extremity addition, stainless steel, any wrist
   L6632          No Change       Latex suspension sleeve each   Upper extremity addition, latex suspension sleeve, each
   L6635          No Change       Lift assist for elbow          Upper extremity addition, lift assist for elbow
   L6637          No Change       Nudge control elbow lock       Upper extremity addition, nudge control elbow lock
   L6638          No Change       Elec lock on manual pw elbow   Upper extremity addition to prosthesis, electric locking feat
   L6640          No Change       Shoulder abduction joint pai   Upper extremity additions, shoulder abduction joint, pair
   L6641          No Change       Excursion amplifier pulley t   Upper extremity addition, excursion amplifier, pulley type
   L6642          No Change       Excursion amplifier lever ty   Upper extremity addition, excursion amplifier, lever type
   L6645          No Change       Shoulder flexion-abduction j   Upper extremity addition, shoulder flexion-abduction joint, e
   L6646          No Change       Multipo locking shoulder jnt   Upper extremity addition, shoulder joint, multipositional loc
   L6647          No Change       Shoulder lock actuator         Upper extremity addition, shoulder lock mechanism, body power
   L6648          No Change       Ext pwrd shlder lock/unlock    Upper extremity addition, shoulder lock mechanism, external p
   L6650          No Change       Shoulder universal joint       Upper extremity addition, shoulder universal joint, each
   L6655          No Change       Standard control cable extra   Upper extremity addition, standard control cable, extra
   L6660          No Change       Heavy duty control cable       Upper extremity addition, heavy duty control cable
   L6665          No Change       Teflon or equal cable lining   Upper extremity addition, teflon, or equal, cable lining
   L6670          No Change       Hook to hand cable adapter     Upper extremity addition, hook to hand, cable adapter
   L6672          No Change       Harness chest/shlder saddle    Upper extremity addition, harness, chest or shoulder, saddle
   L6675          No Change       Harness figure of 8 sing con   Upper extremity addition, harness, (e.g., figure of eight typ
   L6676          No Change       Harness figure of 8 dual con   Upper extremity addition, harness, (e.g., figure of eight typ
   L6677          No Change       Ue triple control harness      Upper extremity addition, harness, triple control, simultaneo
   L6680          No Change       Test sock wrist disart/bel e   Upper extremity addition, test socket, wrist disarticulation
   L6682          No Change       Test sock elbw disart/above    Upper extremity addition, test socket, elbow disarticulation
   L6684          No Change       Test socket shldr disart/tho   Upper extremity addition, test socket, shoulder disarticulati
   L6686          No Change       Suction socket                 Upper extremity addition, suction socket
   L6687          No Change       Frame typ socket bel elbow/w   Upper extremity addition, frame type socket, below elbow or w
   L6688          No Change       Frame typ sock above elb/dis   Upper extremity addition, frame type socket, above elbow or e
   L6689          No Change       Frame typ socket shoulder di   Upper extremity addition, frame type socket, shoulder disarti
   L6690          No Change       Frame typ sock interscap-tho   Upper extremity addition, frame type socket, interscapular-th
   L6691          No Change       Removable insert each          Upper extremity addition, removable insert, each
   L6692          No Change       Silicone gel insert or equal   Upper extremity addition, silicone gel insert or equal, each
   L6693          No Change       Lockingelbow forearm cntrbal   Upper extremity addition, locking elbow, forearm counterbalan
   L6694          No Change       Elbow socket ins use w/lock    Addition to upper extremity prosthesis, below elbow/above elb
   L6695          No Change       Elbow socket ins use w/o lck   Addition to upper extremity prosthesis, below elbow/above elb
   L6696          No Change       Cus elbo skt in for con/atyp   Addition to upper extremity prosthesis, below elbow/above elb
   L6697          No Change       Cus elbo skt in not con/atyp   Addition to upper extremity prosthesis, below elbow/above elb
   L6698          No Change       Below/above elbow lock mech    Addition to upper extremity prosthesis, below elbow/above elb
   L6703          No Change       Term dev, passive hand mitt    Terminal device, passive hand/mitt, any material, any size
   L6704          No Change       Term dev, sport/rec/work att   Terminal device, sport/recreational/work attachment, any mate
   L6706          No Change       Term dev mech hook vol open    Terminal device, hook, mechanical, voluntary opening, any mat
   L6707          No Change       Term dev mech hook vol close   Terminal device, hook, mechanical, voluntary closing, any mat
   L6708          No Change       Term dev mech hand vol open    Terminal device, hand, mechanical, voluntary opening, any mat
   L6709          No Change       Term dev mech hand vol close   Terminal device, hand, mechanical, voluntary closing, any mat
   L6711          No Change       Ped term dev, hook, vol open   Terminal device, hook, mechanical, voluntary opening, any mat
   L6712          No Change       Ped term dev, hook, vol clos   Terminal device, hook, mechanical, voluntary closing, any mat
   L6713          No Change       Ped term dev, hand, vol open   Terminal device, hand, mechanical, voluntary opening, any mat
   L6714          No Change       Ped term dev, hand, vol clos   Terminal device, hand, mechanical, voluntary closing, any mat
   L6715          No Change       Term device, multi art digit   Terminal device, multiple articulating digit, includes motor(
   L6721          No Change       Hook/hand, hvy dty, vol open   Terminal device, hook or hand, heavy duty, mechanical, volunt
   L6722          No Change       Hook/hand, hvy dty, vol clos   Terminal device, hook or hand, heavy duty, mechanical, volunt
   L6805          No Change       Term dev modifier wrist unit   Addition to terminal device, modifier wrist unit
   L6810          No Change       Term dev precision pinch dev   Addition to terminal device, precision pinch device
   L6880          No Change       Elec hand ind art digits       Electric hand, switch or myoelectric controlled, independentl
   L6881          No Change       Term dev auto grasp feature    Automatic grasp feature, addition to upper limb electric pros
   L6882          No Change       Microprocessor control uplmb   Microprocessor control feature, addition to upper limb prosth
   L6883          No Change       Replc sockt below e/w disa     Replacement socket, below elbow/wrist disarticulation, molded
   L6884          No Change       Replc sockt above elbow disa   Replacement socket, above elbow/elbow disarticulation, molded
   L6885          No Change       Replc sockt shldr dis/interc   Replacement socket, shoulder disarticulation/interscapular th
   L6890          No Change       Prefab glove for term device   Addition to upper extremity prosthesis, glove for terminal de
   L6895          No Change       Custom glove for term device   Addition to upper extremity prosthesis, glove for terminal de
   L6900          No Change       Hand restorat thumb/1 finger   Hand restoration (casts, shading and measurements included),
   L6905          No Change       Hand restoration multiple fi   Hand restoration (casts, shading and measurements included),
   L6910          No Change       Hand restoration no fingers    Hand restoration (casts, shading and measurements included),
   L6915          No Change       Hand restoration replacmnt g   Hand restoration (shading, and measurements included), replac
   L6920          No Change       Wrist disarticul switch ctrl   Wrist disarticulation, external power, self-suspended inner s
   L6925          No Change       Wrist disart myoelectronic c   Wrist disarticulation, external power, self-suspended inner s
   L6930          No Change       Below elbow switch control     Below elbow, external power, self-suspended inner socket, rem
   L6935          No Change       Below elbow myoelectronic ct   Below elbow, external power, self-suspended inner socket, rem
   L6940          No Change       Elbow disarticulation switch   Elbow disarticulation, external power, molded inner socket, r
   L6945          No Change       Elbow disart myoelectronic c   Elbow disarticulation, external power, molded inner socket, r
   L6950          No Change       Above elbow switch control     Above elbow, external power, molded inner socket, removable h
   L6955          No Change       Above elbow myoelectronic ct   Above elbow, external power, molded inner socket, removable h
   L6960          No Change       Shldr disartic switch contro   Shoulder disarticulation, external power, molded inner socket
   L6965          No Change       Shldr disartic myoelectronic   Shoulder disarticulation, external power, molded inner socket
   L6970          No Change       Interscapular-thor switch ct   Interscapular-thoracic, external power, molded inner socket,
   L6975          No Change       Interscap-thor myoelectronic   Interscapular-thoracic, external power, molded inner socket,
   L7007          No Change       Adult electric hand            Electric hand, switch or myoelectric controlled, adult
   L7008          No Change       Pediatric electric hand        Electric hand, switch or myoelectric, controlled, pediatric
   L7009          No Change       Adult electric hook            Electric hook, switch or myoelectric controlled, adult
   L7040          No Change       Prehensile actuator            Prehensile actuator, switch controlled
   L7045          No Change       Pediatric electric hook        Electric hook, switch or myoelectric controlled, pediatric
   L7170          No Change       Electronic elbow hosmer swit   Electronic elbow, hosmer or equal, switch controlled
   L7180          No Change       Electronic elbow sequential    Electronic elbow, microprocessor sequential control of elbow
   L7181          No Change       Electronic elbo simultaneous   Electronic elbow, microprocessor simultaneous control of elbo
   L7185          No Change       Electron elbow adolescent sw   Electronic elbow, adolescent, variety village or equal, switc
   L7186          No Change       Electron elbow child switch    Electronic elbow, child, variety village or equal, switch con
   L7190          No Change       Elbow adolescent myoelectron   Electronic elbow, adolescent, variety village or equal, myoel
   L7191          No Change       Elbow child myoelectronic ct   Electronic elbow, child, variety village or equal, myoelectro
   L7259          No Change       Electronic wrist rotator any   Electronic wrist rotator, any type
   L7260          No Change       Electron wrist rotator otto    Electronic wrist rotator, otto bock or equal
   L7261          No Change       Electron wrist rotator utah    Electronic wrist rotator, for utah arm
   L7360          No Change       Six volt bat otto bock/eq ea   Six volt battery, each
   L7362          No Change       Battery chrgr six volt otto    Battery charger, six volt, each
   L7364          No Change       Twelve volt battery utah/equ   Twelve volt battery, each
   L7366          No Change       Battery chrgr 12 volt utah/e   Battery charger, twelve volt, each
   L7367          No Change       Replacemnt lithium ionbatter   Lithium ion battery, rechargeable, replacement
   L7368          No Change       Lithium ion battery charger    Lithium ion battery charger, replacement only
   L7400          No Change       Add ue prost be/wd, ultlite    Addition to upper extremity prosthesis, below elbow/wrist dis
   L7401          No Change       Add ue prost a/e ultlite mat   Addition to upper extremity prosthesis, above elbow disarticu
   L7402          No Change       Add ue prost s/d ultlite mat   Addition to upper extremity prosthesis, shoulder disarticulat
   L7403          No Change       Add ue prost b/e acrylic       Addition to upper extremity prosthesis, below elbow/wrist dis
   L7404          No Change       Add ue prost a/e acrylic       Addition to upper extremity prosthesis, above elbow disarticu
   L7405          No Change       Add ue prost s/d acrylic       Addition to upper extremity prosthesis, shoulder disarticulat
   L7499          No Change       Upper extremity prosthes nos   Upper extremity prosthesis, not otherwise specified
   L7510          No Change       Prosthetic device repair rep   Repair of prosthetic device, repair or replace minor parts
   L7520          No Change       Repair prosthesis per 15 min   Repair prosthetic device, labor component, per 15 minutes
   L7600          No Change       Prosthetic donning sleeve      Prosthetic donning sleeve, any material, each
   L7700          No Change       Pros soc insert gasket/seal    Gasket or seal, for use with prosthetic socket insert, any ty
   L7900          No Change       Male vacuum erection system    Male vacuum erection system
   L7902          No Change       Tension ring, vac erect dev    Tension ring, for vacuum erection device, any type, replaceme
   L8000          No Change       Mastectomy bra                 Breast prosthesis, mastectomy bra, without integrated breast
   L8001          No Change       Breast prosthesis bra & form   Breast prosthesis, mastectomy bra, with integrated breast pro
   L8002          No Change       Brst prsth bra & bilat form    Breast prosthesis, mastectomy bra, with integrated breast pro
   L8010          No Change       Mastectomy sleeve              Breast prosthesis, mastectomy sleeve
   L8015          No Change       Ext breastprosthesis garment   External breast prosthesis garment, with mastectomy form, pos
   L8020          No Change       Mastectomy form                Breast prosthesis, mastectomy form
   L8030          No Change       Breast prosthes w/o adhesive   Breast prosthesis, silicone or equal, without integral adhesi
   L8031          No Change       Breast prosthesis w adhesive   Breast prosthesis, silicone or equal, with integral adhesive
   L8032          No Change       Reusable nipple prosthesis     Nipple prosthesis, reusable, any type, each
   L8035          No Change       Custom breast prosthesis       Custom breast prosthesis, post mastectomy, molded to patient
   L8039          No Change       Breast prosthesis nos          Breast prosthesis, not otherwise specified
   L8040          No Change       Nasal prosthesis               Nasal prosthesis, provided by a non-physician
   L8041          No Change       Midfacial prosthesis           Midfacial prosthesis, provided by a non-physician
   L8042          No Change       Orbital prosthesis             Orbital prosthesis, provided by a non-physician
   L8043          No Change       Upper facial prosthesis        Upper facial prosthesis, provided by a non-physician
   L8044          No Change       Hemi-facial prosthesis         Hemi-facial prosthesis, provided by a non-physician
   L8045          No Change       Auricular prosthesis           Auricular prosthesis, provided by a non-physician
   L8046          No Change       Partial facial prosthesis      Partial facial prosthesis, provided by a non-physician
   L8047          No Change       Nasal septal prosthesis        Nasal septal prosthesis, provided by a non-physician
   L8048          No Change       Unspec maxillofacial prosth    Unspecified maxillofacial prosthesis, by report, provided by
   L8049          No Change       Repair maxillofacial prosth    Repair or modification of maxillofacial prosthesis, labor com
   L8300          No Change       Truss single w/ standard pad   Truss, single with standard pad
   L8310          No Change       Truss double w/ standard pad   Truss, double with standard pads
   L8320          No Change       Truss addition to std pad wa   Truss, addition to standard pad, water pad
   L8330          No Change       Truss add to std pad scrotal   Truss, addition to standard pad, scrotal pad
   L8400          No Change       Sheath below knee              Prosthetic sheath, below knee, each
   L8410          No Change       Sheath above knee              Prosthetic sheath, above knee, each
   L8415          No Change       Sheath upper limb              Prosthetic sheath, upper limb, each
   L8417          No Change       Pros sheath/sock w gel cushn   Prosthetic sheath/sock, including a gel cushion layer, below
   L8420          No Change       Prosthetic sock multi ply bk   Prosthetic sock, multiple ply, below knee, each
   L8430          No Change       Prosthetic sock multi ply ak   Prosthetic sock, multiple ply, above knee, each
   L8435          No Change       Pros sock multi ply upper lm   Prosthetic sock, multiple ply, upper limb, each
   L8440          No Change       Shrinker below knee            Prosthetic shrinker, below knee, each
   L8460          No Change       Shrinker above knee            Prosthetic shrinker, above knee, each
   L8465          No Change       Shrinker upper limb            Prosthetic shrinker, upper limb, each
   L8470          No Change       Pros sock single ply bk        Prosthetic sock, single ply, fitting, below knee, each
   L8480          No Change       Pros sock single ply ak        Prosthetic sock, single ply, fitting, above knee, each
   L8485          No Change       Pros sock single ply upper l   Prosthetic sock, single ply, fitting, upper limb, each
   L8499          No Change       Unlisted misc prosthetic ser   Unlisted procedure for miscellaneous prosthetic services
   L8500          No Change       Artificial larynx              Artificial larynx, any type
   L8501          No Change       Tracheostomy speaking valve    Tracheostomy speaking valve
   L8505          No Change       Artificial larynx, accessory   Artificial larynx replacement battery / accessory, any type
   L8507          No Change       Trach-esoph voice pros pt in   Tracheo-esophageal voice prosthesis, patient inserted, any ty
   L8509          No Change       Trach-esoph voice pros md in   Tracheo-esophageal voice prosthesis, inserted by a licensed h
   L8510          No Change       Voice amplifier                Voice amplifier
   L8511          No Change       Indwelling trach insert        Insert for indwelling tracheoesophageal prosthesis, with or w
   L8512          No Change       Gel cap for trach voice pros   Gelatin capsules or equivalent, for use with tracheoesophagea
   L8513          No Change       Trach pros cleaning device     Cleaning device used with tracheoesophageal voice prosthesis,
   L8514          No Change       Repl trach puncture dilator    Tracheoesophageal puncture dilator, replacement only, each
   L8515          No Change       Gel cap app device for trach   Gelatin capsule, application device for use with tracheoesoph
   L8600          No Change       Implant breast silicone/eq     Implantable breast prosthesis, silicone or equal
   L8603          No Change       Collagen imp urinary 2.5 ml    Injectable bulking agent, collagen implant, urinary tract, 2.
   L8604          No Change       Dextranomer/hyaluronic acid    Injectable bulking agent, dextranomer/hyaluronic acid copolym
   L8605          No Change       Inj bulking agent anal canal   Injectable bulking agent, dextranomer/hyaluronic acid copolym
   L8606          No Change       Synthetic implnt urinary 1ml   Injectable bulking agent, synthetic implant, urinary tract, 1
   L8607          No Change       Inj vocal cord bulking agent   Injectable bulking agent for vocal cord medialization, 0.1 ml
   L8609          No Change       Artificial cornea              Artificial cornea
   L8610          No Change       Ocular implant                 Ocular implant
   L8612          No Change       Aqueous shunt prosthesis       Aqueous shunt
   L8613          No Change       Ossicular implant              Ossicula implant
   L8614          No Change       Cochlear device                Cochlear device, includes all internal and external component
   L8615          No Change       Coch implant headset replace   Headset/headpiece for use with cochlear implant device, repla
   L8616          No Change       Coch implant microphone repl   Microphone for use with cochlear implant device, replacement
   L8617          No Change       Coch implant trans coil repl   Transmitting coil for use with cochlear implant device, repla
   L8618          No Change       Coch implant tran cable repl   Transmitter cable for use with cochlear implant device or aud
   L8619          No Change       Coch imp ext proc/contr rplc   Cochlear implant, external speech processor and controller, i
   L8621          No Change       Repl zinc air battery          Zinc air battery for use with cochlear implant device and aud
   L8622          No Change       Repl alkaline battery          Alkaline battery for use with cochlear implant device, any si
   L8623          No Change       Lith ion batt cid,non-earlvl   Lithium ion battery for use with cochlear implant device spee
   L8624          No Change       Lith ion batt cid, ear level   Lithium ion battery for use with cochlear implant or auditory
   L8625          No Change       Charger coch impl/aoi battry   External recharging system for battery for use with cochlear
   L8627          No Change       Cid ext speech process repl    Cochlear implant, external speech processor, component, repla
   L8628          No Change       Cid ext controller repl        Cochlear implant, external controller component, replacement
   L8629          No Change       Cid transmit coil and cable    Transmitting coil and cable, integrated, for use with cochlea
   L8630          No Change       Metacarpophalangeal implant    Metacarpophalangeal joint implant
   L8631          No Change       Mcp joint repl 2 pc or more    Metacarpal phalangeal joint replacement, two or more pieces,
   L8641          No Change       Metatarsal joint implant       Metatarsal joint implant
   L8642          No Change       Hallux implant                 Hallux implant
   L8658          No Change       Interphalangeal joint spacer   Interphalangeal joint spacer, silicone or equal, each
   L8659          No Change       Interphalangeal joint repl     Interphalangeal finger joint replacement, 2 or more pieces, m
   L8670          No Change       Vascular graft, synthetic      Vascular graft material, synthetic, implant
   L8679          No Change       Imp neurosti pls gn any type   Implantable neurostimulator, pulse generator, any type
   L8680          No Change       Implt neurostim elctr each     Implantable neurostimulator electrode, each
   L8681          No Change       Pt prgrm for implt neurostim   Patient programmer (external) for use with implantable progra
   L8682          No Change       Implt neurostim radiofq rec    Implantable neurostimulator radiofrequency receiver
   L8683          No Change       Radiofq trsmtr for implt neu   Radiofrequency transmitter (external) for use with implantabl
   L8684          No Change       Radiof trsmtr implt scrl neu   Radiofrequency transmitter (external) for use with implantabl
   L8685          No Change       Implt nrostm pls gen sng rec   Implantable neurostimulator pulse generator, single array, re
   L8686          No Change       Implt nrostm pls gen sng non   Implantable neurostimulator pulse generator, single array, no
   L8687          No Change       Implt nrostm pls gen dua rec   Implantable neurostimulator pulse generator, dual array, rech
   L8688          No Change       Implt nrostm pls gen dua non   Implantable neurostimulator pulse generator, dual array, non-
   L8689          No Change       External recharg sys intern    External recharging system for battery (internal) for use wit
   L8690          No Change       Aud osseo dev, int/ext comp    Auditory osseointegrated device, includes all internal and ex
   L8691          No Change       Aoi snd proc repl excl actua   Auditory osseointegrated device, external sound processor, ex
   L8692          No Change       Non-osseointegrated snd proc   Auditory osseointegrated device, external sound processor, us
   L8693          No Change       Aud osseo dev, abutment        Auditory osseointegrated device abutment, any length, replace
   L8694          No Change       Aoi transducer/actuator repl   Auditory osseointegrated device, transducer/actuator, replace
   L8695          No Change       External recharg sys extern    External recharging system for battery (external) for use wit
   L8696          No Change       Ext antenna phren nerve stim   Antenna (external) for use with implantable diaphragmatic/phr
   L8699          No Change       Prosthetic implant nos         Prosthetic implant, not otherwise specified
   L9900          No Change       O&p supply/accessory/service   Orthotic and prosthetic supply, accessory, and/or service com
   M0064          No Change       Visit for drug monitoring      Brief office visit for the sole purpose of monitoring or chan
   M0075          No Change       Cellular therapy               Cellular therapy
   M0076          No Change       Prolotherapy                   Prolotherapy
   M0100          No Change       Intragastric hypothermia       Intragastric hypothermia using gastric freezing
   M0300          No Change       Iv chelationtherapy            Iv chelation therapy (chemical endarterectomy)
   M0301          No Change       Fabric wrapping of aneurysm    Fabric wrapping of abdominal aneurysm
   P2028          No Change       Cephalin floculation test      Cephalin floculation, blood
   P2029          No Change       Congo red blood test           Congo red, blood
   P2031          No Change       Hair analysis                  Hair analysis (excluding arsenic)
   P2033          No Change       Blood thymol turbidity         Thymol turbidity, blood
   P2038          No Change       Blood mucoprotein              Mucoprotein, blood (seromucoid) (medical necessity procedure)
   P3000          No Change       Screen pap by tech w md supv   Screening papanicolaou smear, cervical or vaginal, up to thre
   P3001          No Change       Screening pap smear by phys    Screening papanicolaou smear, cervical or vaginal, up to thre
   P7001          No Change       Culture bacterial urine        Culture, bacterial, urine; quantitative, sensitivity study
   P9010          No Change       Whole blood for transfusion    Blood (whole), for transfusion, per unit
   P9011          No Change       Blood split unit               Blood, split unit
   P9012          No Change       Cryoprecipitate each unit      Cryoprecipitate, each unit
   P9016          No Change       Rbc leukocytes reduced         Red blood cells, leukocytes reduced, each unit
   P9017          No Change       Plasma 1 donor frz w/in 8 hr   Fresh frozen plasma (single donor), frozen within 8 hours of
   P9019          No Change       Platelets, each unit           Platelets, each unit
   P9020          No Change       Plaelet rich plasma unit       Platelet rich plasma, each unit
   P9021          No Change       Red blood cells unit           Red blood cells, each unit
   P9022          No Change       Washed red blood cells unit    Red blood cells, washed, each unit
   P9023          No Change       Frozen plasma, pooled, sd      Plasma, pooled multiple donor, solvent/detergent treated, fro
   P9031          No Change       Platelets leukocytes reduced   Platelets, leukocytes reduced, each unit
   P9032          No Change       Platelets, irradiated          Platelets, irradiated, each unit
   P9033          No Change       Platelets leukoreduced irrad   Platelets, leukocytes reduced, irradiated, each unit
   P9034          No Change       Platelets, pheresis            Platelets, pheresis, each unit
   P9035          No Change       Platelet pheres leukoreduced   Platelets, pheresis, leukocytes reduced, each unit
   P9036          No Change       Platelet pheresis irradiated   Platelets, pheresis, irradiated, each unit
   P9037          No Change       Plate pheres leukoredu irrad   Platelets, pheresis, leukocytes reduced, irradiated, each uni
   P9038          No Change       Rbc irradiated                 Red blood cells, irradiated, each unit
   P9039          No Change       Rbc deglycerolized             Red blood cells, deglycerolized, each unit
   P9040          No Change       Rbc leukoreduced irradiated    Red blood cells, leukocytes reduced, irradiated, each unit
   P9041          No Change       Albumin (human),5%, 50ml       Infusion, albumin (human), 5%, 50 ml
   P9043          No Change       Plasma protein fract,5%,50ml   Infusion, plasma protein fraction (human), 5%, 50 ml
   P9044          No Change       Cryoprecipitatereducedplasma   Plasma, cryoprecipitate reduced, each unit
   P9045          No Change       Albumin (human), 5%, 250 ml    Infusion, albumin (human), 5%, 250 ml
   P9046          No Change       Albumin (human), 25%, 20 ml    Infusion, albumin (human), 25%, 20 ml
   P9047          No Change       Albumin (human), 25%, 50ml     Infusion, albumin (human), 25%, 50 ml
   P9048          No Change       Plasmaprotein fract,5%,250ml   Infusion, plasma protein fraction (human), 5%, 250 ml
   P9050          No Change       Granulocytes, pheresis unit    Granulocytes, pheresis, each unit
   P9051          No Change       Blood, l/r, cmv-neg            Whole blood or red blood cells, leukocytes reduced, cmv-negat
   P9052          No Change       Platelets, hla-m, l/r, unit    Platelets, hla-matched leukocytes reduced, apheresis/pheresis
   P9053          No Change       Plt, pher, l/r cmv-neg, irr    Platelets, pheresis, leukocytes reduced, cmv-negative, irradi
   P9054          No Change       Blood, l/r, froz/degly/wash    Whole blood or red blood cells, leukocytes reduced, frozen, d
   P9055          No Change       Plt, aph/pher, l/r, cmv-neg    Platelets, leukocytes reduced, cmv-negative, apheresis/pheres
   P9056          No Change       Blood, l/r, irradiated         Whole blood, leukocytes reduced, irradiated, each unit
   P9057          No Change       Rbc, frz/deg/wsh, l/r, irrad   Red blood cells, frozen/deglycerolized/washed, leukocytes red
   P9058          No Change       Rbc, l/r, cmv-neg, irrad       Red blood cells, leukocytes reduced, cmv-negative, irradiated
   P9059          No Change       Plasma, frz between 8-24hour   Fresh frozen plasma between 8-24 hours of collection, each un
   P9060          No Change       Fr frz plasma donor retested   Fresh frozen plasma, donor retested, each unit
   P9070          No Change       Pathogen reduced plasma pool   Plasma, pooled multiple donor, pathogen reduced, frozen, each
   P9071          No Change       Pathogen reduced plasma sing   Plasma (single donor), pathogen reduced, frozen, each unit
   P9072          No Change       Plate path red/rapid bac tes   Platelets, pheresis, pathogen reduced or rapid bacterial test
   P9100          No Change       Pathogen test for platelets    Pathogen(s) test for platelets
   P9603          No Change       One-way allow prorated miles   Travel allowance one way in connection with medically necessa
   P9604          No Change       One-way allow prorated trip    Travel allowance one way in connection with medically necessa
   P9612          No Change       Catheterize for urine spec     Catheterization for collection of specimen, single patient, a
   P9615          No Change       Urine specimen collect mult    Catheterization for collection of specimen(s) (multiple patie
   Q0035          No Change       Cardiokymography               Cardiokymography
   Q0081          No Change       Infusion ther other than che   Infusion therapy, using other than chemotherapeutic drugs, pe
   Q0083          No Change       Chemo by other than infusion   Chemotherapy administration by other than infusion technique
   Q0084          No Change       Chemotherapy by infusion       Chemotherapy administration by infusion technique only, per v
   Q0085          No Change       Chemo by both infusion and o   Chemotherapy administration by both infusion technique and ot
   Q0091          No Change       Obtaining screen pap smear     Screening papanicolaou smear; obtaining, preparing and convey
   Q0092          No Change       Set up port xray equipment     Set-up portable x-ray equipment
   Q0111          No Change       Wet mounts/ w preparations     Wet mounts, including preparations of vaginal, cervical or sk
   Q0112          No Change       Potassium hydroxide preps      All potassium hydroxide (koh) preparations
   Q0113          No Change       Pinworm examinations           Pinworm examinations
   Q0114          No Change       Fern test                      Fern test
   Q0115          No Change       Post-coital mucous exam        Post-coital direct, qualitative examinations of vaginal or ce
   Q0138          No Change       Ferumoxytol, non-esrd          Injection, ferumoxytol, for treatment of iron deficiency anem
   Q0139          No Change       Ferumoxytol, esrd use          Injection, ferumoxytol, for treatment of iron deficiency anem
   Q0144          No Change       Azithromycin dihydrate, oral   Azithromycin dihydrate, oral, capsules/powder, 1 gram
   Q0161          No Change       Chlorpromazine hcl 5mg oral    Chlorpromazine hydrochloride, 5 mg, oral, fda approved prescr
   Q0162          No Change       Ondansetron oral               Ondansetron 1 mg, oral, fda approved prescription anti-emetic
   Q0163          No Change       Diphenhydramine hcl 50mg       Diphenhydramine hydrochloride, 50 mg, oral, fda approved pres
   Q0164          No Change       Prochlorperazine maleate 5mg   Prochlorperazine maleate, 5 mg, oral, fda approved prescripti
   Q0166          No Change       Granisetron hcl 1 mg oral      Granisetron hydrochloride, 1 mg, oral, fda approved prescript
   Q0167          No Change       Dronabinol 2.5mg oral          Dronabinol, 2.5 mg, oral, fda approved prescription anti-emet
   Q0169          No Change       Promethazine hcl 12.5mg oral   Promethazine hydrochloride, 12.5 mg, oral, fda approved presc
   Q0173          No Change       Trimethobenzamide hcl 250mg    Trimethobenzamide hydrochloride, 250 mg, oral, fda approved p
   Q0174          No Change       Thiethylperazine maleate10mg   Thiethylperazine maleate, 10 mg, oral, fda approved prescript
   Q0175          No Change       Perphenazine 4mg oral          Perphenazine, 4 mg, oral, fda approved prescription anti-emet
   Q0177          No Change       Hydroxyzine pamoate 25mg       Hydroxyzine pamoate, 25 mg, oral, fda approved prescription a
   Q0180          No Change       Dolasetron mesylate oral       Dolasetron mesylate, 100 mg, oral, fda approved prescription
   Q0181          No Change       Unspecified oral anti-emetic   Unspecified oral dosage form, fda approved prescription anti-
   Q0477          No Change       Pwr module pt cable lvad rpl   Power module patient cable for use with electric or electric/
   Q0478          No Change       Power adapter, combo vad       Power adapter for use with electric or electric/pneumatic ven
   Q0479          No Change       Power module combo vad, rep    Power module for use with electric or electric/pneumatic vent
   Q0480          No Change       Driver pneumatic vad, rep      Driver for use with pneumatic ventricular assist device, repl
   Q0481          No Change       Microprcsr cu elec vad, rep    Microprocessor control unit for use with electric ventricular
   Q0482          No Change       Microprcsr cu combo vad, rep   Microprocessor control unit for use with electric/pneumatic c
   Q0483          No Change       Monitor elec vad, rep          Monitor/display module for use with electric ventricular assi
   Q0484          No Change       Monitor elec or comb vad rep   Monitor/display module for use with electric or electric/pneu
   Q0485          No Change       Monitor cable elec vad, rep    Monitor control cable for use with electric ventricular assis
   Q0486          No Change       Mon cable elec/pneum vad rep   Monitor control cable for use with electric/pneumatic ventric
   Q0487          No Change       Leads any type vad, rep only   Leads (pneumatic/electrical) for use with any type electric/p
   Q0488          No Change       Pwr pack base elec vad, rep    Power pack base for use with electric ventricular assist devi
   Q0489          No Change       Pwr pck base combo vad, rep    Power pack base for use with electric/pneumatic ventricular a
   Q0490          No Change       Emr pwr source elec vad, rep   Emergency power source for use with electric ventricular assi
   Q0491          No Change       Emr pwr source combo vad rep   Emergency power source for use with electric/pneumatic ventri
   Q0492          No Change       Emr pwr cbl elec vad, rep      Emergency power supply cable for use with electric ventricula
   Q0493          No Change       Emr pwr cbl combo vad, rep     Emergency power supply cable for use with electric/pneumatic
   Q0494          No Change       Emr hd pmp elec/combo, rep     Emergency hand pump for use with electric or electric/pneumat
   Q0495          No Change       Charger elec/combo vad, rep    Battery/power pack charger for use with electric or electric/
   Q0496          No Change       Battery elec/combo vad, rep    Battery, other than lithium-ion, for use with electric or ele
   Q0497          No Change       Bat clps elec/comb vad, rep    Battery clips for use with electric or electric/pneumatic ven
   Q0498          No Change       Holster elec/combo vad, rep    Holster for use with electric or electric/pneumatic ventricul
   Q0499          No Change       Belt/vest elec/combo vad rep   Belt/vest/bag for use to carry external peripheral components
   Q0500          No Change       Filters elec/combo vad, rep    Filters for use with electric or electric/pneumatic ventricul
   Q0501          No Change       Shwr cov elec/combo vad, rep   Shower cover for use with electric or electric/pneumatic vent
   Q0502          No Change       Mobility cart pneum vad, rep   Mobility cart for pneumatic ventricular assist device, replac
   Q0503          No Change       Battery pneum vad replacemnt   Battery for pneumatic ventricular assist device, replacement
   Q0504          No Change       Pwr adpt pneum vad, rep veh    Power adapter for pneumatic ventricular assist device, replac
   Q0506          No Change       Lith-ion batt elec/pneum vad   Battery, lithium-ion, for use with electric or electric/pneum
   Q0507          No Change       Misc sup/acc ext vad           Miscellaneous supply or accessory for use with an external ve
   Q0508          No Change       Mis sup/acc imp vad            Miscellaneous supply or accessory for use with an implanted v
   Q0509          No Change       Mis sup/ac imp vad nopay med   Miscellaneous supply or accessory for use with any implanted
   Q0510          No Change       Dispens fee immunosupressive   Pharmacy supply fee for initial immunosuppressive drug(s), fi
   Q0511          No Change       Sup fee antiem,antica,immuno   Pharmacy supply fee for oral anti-cancer, oral anti-emetic or
   Q0512          No Change       Px sup fee anti-can sub pres   Pharmacy supply fee for oral anti-cancer, oral anti-emetic or
   Q0513          No Change       Disp fee inhal drugs/30 days   Pharmacy dispensing fee for inhalation drug(s); per 30 days
   Q0514          No Change       Disp fee inhal drugs/90 days   Pharmacy dispensing fee for inhalation drug(s); per 90 days
   Q0515          No Change       Sermorelin acetate injection   Injection, sermorelin acetate, 1 microgram
   Q1004          No Change       Ntiol category 4               New technology intraocular lens category 4 as defined in fede
   Q1005          No Change       Ntiol category 5               New technology intraocular lens category 5 as defined in fede
   Q2004          No Change       Bladder calculi irrig sol      Irrigation solution for treatment of bladder calculi, for exa
   Q2017          No Change       Teniposide, 50 mg              Injection, teniposide, 50 mg
   Q2034          No Change       Agriflu vaccine                Influenza virus vaccine, split virus, for intramuscular use (
   Q2035          No Change       Afluria vacc, 3 yrs & >, im    Influenza virus vaccine, split virus, when administered to in
   Q2036          No Change       Flulaval vacc, 3 yrs & >, im   Influenza virus vaccine, split virus, when administered to in
   Q2037          No Change       Fluvirin vacc, 3 yrs & >, im   Influenza virus vaccine, split virus, when administered to in
   Q2038          No Change       Fluzone vacc, 3 yrs & >, im    Influenza virus vaccine, split virus, when administered to in
   Q2039          No Change       Influenza virus vaccine, nos   Influenza virus vaccine, not otherwise specified
   Q2043          No Change       Sipuleucel-t auto cd54+        Sipuleucel-t, minimum of 50 million autologous cd54+ cells ac
   Q2049          No Change       Imported lipodox inj           Injection, doxorubicin hydrochloride, liposomal, imported lip
   Q2050          No Change       Doxorubicin inj 10mg           Injection, doxorubicin hydrochloride, liposomal, not otherwis
   Q2052          No Change       Ivig demo, services/supplies   Services, supplies and accessories used in the home under the
   Q3001          No Change       Brachytherapy radioelements    Radioelements for brachytherapy, any type, each
   Q3014          No Change       Telehealth facility fee        Telehealth originating site facility fee
   Q3027          No Change       Inj beta interferon im 1 mcg   Injection, interferon beta-1a, 1 mcg for intramuscular use
   Q3028          No Change       Inj beta interferon sq 1 mcg   Injection, interferon beta-1a, 1 mcg for subcutaneous use
   Q3031          No Change       Collagen skin test             Collagen skin test
   Q4001          No Change       Cast sup body cast plaster     Casting supplies, body cast adult, with or without head, plas
   Q4002          No Change       Cast sup body cast fiberglas   Cast supplies, body cast adult, with or without head, fibergl
   Q4003          No Change       Cast sup shoulder cast plstr   Cast supplies, shoulder cast, adult (11 years +), plaster
   Q4004          No Change       Cast sup shoulder cast fbrgl   Cast supplies, shoulder cast, adult (11 years +), fiberglass
   Q4005          No Change       Cast sup long arm adult plst   Cast supplies, long arm cast, adult (11 years +), plaster
   Q4006          No Change       Cast sup long arm adult fbrg   Cast supplies, long arm cast, adult (11 years +), fiberglass
   Q4007          No Change       Cast sup long arm ped plster   Cast supplies, long arm cast, pediatric (0-10 years), plaster
   Q4008          No Change       Cast sup long arm ped fbrgls   Cast supplies, long arm cast, pediatric (0-10 years), fibergl
   Q4009          No Change       Cast sup sht arm adult plstr   Cast supplies, short arm cast, adult (11 years +), plaster
   Q4010          No Change       Cast sup sht arm adult fbrgl   Cast supplies, short arm cast, adult (11 years +), fiberglass
   Q4011          No Change       Cast sup sht arm ped plaster   Cast supplies, short arm cast, pediatric (0-10 years), plaste
   Q4012          No Change       Cast sup sht arm ped fbrglas   Cast supplies, short arm cast, pediatric (0-10 years), fiberg
   Q4013          No Change       Cast sup gauntlet plaster      Cast supplies, gauntlet cast (includes lower forearm and hand
   Q4014          No Change       Cast sup gauntlet fiberglass   Cast supplies, gauntlet cast (includes lower forearm and hand
   Q4015          No Change       Cast sup gauntlet ped plster   Cast supplies, gauntlet cast (includes lower forearm and hand
   Q4016          No Change       Cast sup gauntlet ped fbrgls   Cast supplies, gauntlet cast (includes lower forearm and hand
   Q4017          No Change       Cast sup lng arm splint plst   Cast supplies, long arm splint, adult (11 years +), plaster
   Q4018          No Change       Cast sup lng arm splint fbrg   Cast supplies, long arm splint, adult (11 years +), fiberglas
   Q4019          No Change       Cast sup lng arm splnt ped p   Cast supplies, long arm splint, pediatric (0-10 years), plast
   Q4020          No Change       Cast sup lng arm splnt ped f   Cast supplies, long arm splint, pediatric (0-10 years), fiber
   Q4021          No Change       Cast sup sht arm splint plst   Cast supplies, short arm splint, adult (11 years +), plaster
   Q4022          No Change       Cast sup sht arm splint fbrg   Cast supplies, short arm splint, adult (11 years +), fibergla
   Q4023          No Change       Cast sup sht arm splnt ped p   Cast supplies, short arm splint, pediatric (0-10 years), plas
   Q4024          No Change       Cast sup sht arm splnt ped f   Cast supplies, short arm splint, pediatric (0-10 years), fibe
   Q4025          No Change       Cast sup hip spica plaster     Cast supplies, hip spica (one or both legs), adult (11 years
   Q4026          No Change       Cast sup hip spica fiberglas   Cast supplies, hip spica (one or both legs), adult (11 years
   Q4027          No Change       Cast sup hip spica ped plstr   Cast supplies, hip spica (one or both legs), pediatric (0-10
   Q4028          No Change       Cast sup hip spica ped fbrgl   Cast supplies, hip spica (one or both legs), pediatric (0-10
   Q4029          No Change       Cast sup long leg plaster      Cast supplies, long leg cast, adult (11 years +), plaster
   Q4030          No Change       Cast sup long leg fiberglass   Cast supplies, long leg cast, adult (11 years +), fiberglass
   Q4031          No Change       Cast sup lng leg ped plaster   Cast supplies, long leg cast, pediatric (0-10 years), plaster
   Q4032          No Change       Cast sup lng leg ped fbrgls    Cast supplies, long leg cast, pediatric (0-10 years), fibergl
   Q4033          No Change       Cast sup lng leg cylinder pl   Cast supplies, long leg cylinder cast, adult (11 years +), pl
   Q4034          No Change       Cast sup lng leg cylinder fb   Cast supplies, long leg cylinder cast, adult (11 years +), fi
   Q4035          No Change       Cast sup lngleg cylndr ped p   Cast supplies, long leg cylinder cast, pediatric (0-10 years)
   Q4036          No Change       Cast sup lngleg cylndr ped f   Cast supplies, long leg cylinder cast, pediatric (0-10 years)
   Q4037          No Change       Cast sup shrt leg plaster      Cast supplies, short leg cast, adult (11 years +), plaster
   Q4038          No Change       Cast sup shrt leg fiberglass   Cast supplies, short leg cast, adult (11 years +), fiberglass
   Q4039          No Change       Cast sup shrt leg ped plster   Cast supplies, short leg cast, pediatric (0-10 years), plaste
   Q4040          No Change       Cast sup shrt leg ped fbrgls   Cast supplies, short leg cast, pediatric (0-10 years), fiberg
   Q4041          No Change       Cast sup lng leg splnt plstr   Cast supplies, long leg splint, adult (11 years +), plaster
   Q4042          No Change       Cast sup lng leg splnt fbrgl   Cast supplies, long leg splint, adult (11 years +), fiberglas
   Q4043          No Change       Cast sup lng leg splnt ped p   Cast supplies, long leg splint, pediatric (0-10 years), plast
   Q4044          No Change       Cast sup lng leg splnt ped f   Cast supplies, long leg splint, pediatric (0-10 years), fiber
   Q4045          No Change       Cast sup sht leg splnt plstr   Cast supplies, short leg splint, adult (11 years +), plaster
   Q4046          No Change       Cast sup sht leg splnt fbrgl   Cast supplies, short leg splint, adult (11 years +), fibergla
   Q4047          No Change       Cast sup sht leg splnt ped p   Cast supplies, short leg splint, pediatric (0-10 years), plas
   Q4048          No Change       Cast sup sht leg splnt ped f   Cast supplies, short leg splint, pediatric (0-10 years), fibe
   Q4049          No Change       Finger splint, static          Finger splint, static
   Q4050          No Change       Cast supplies unlisted         Cast supplies, for unlisted types and materials of casts
   Q4051          No Change       Splint supplies misc           Splint supplies, miscellaneous (includes thermoplastics, stra
   Q4074          No Change       Iloprost non-comp unit dose    Iloprost, inhalation solution, fda-approved final product, no
   Q4081          No Change       Epoetin alfa, 100 units esrd   Injection, epoetin alfa, 100 units (for esrd on dialysis)
   Q4082          No Change       Drug/bio noc part b drug cap   Drug or biological, not otherwise classified, part b drug com
   Q4100          No Change       Skin substitute, nos           Skin substitute, not otherwise specified
   Q4101          No Change       Apligraf                       Apligraf, per square centimeter
   Q4102          No Change       Oasis wound matrix             Oasis wound matrix, per square centimeter
   Q4103          No Change       Oasis burn matrix              Oasis burn matrix, per square centimeter
   Q4104          No Change       Integra bmwd                   Integra bilayer matrix wound dressing (bmwd), per square cent
   Q4105          No Change       Integra drt or omnigraft       Integra dermal regeneration template (drt) or integra omnigra
   Q4106          No Change       Dermagraft                     Dermagraft, per square centimeter
   Q4107          No Change       Graftjacket                    Graftjacket, per square centimeter
   Q4108          No Change       Integra matrix                 Integra matrix, per square centimeter
   Q4110          No Change       Primatrix                      Primatrix, per square centimeter
   Q4111          No Change       Gammagraft                     Gammagraft, per square centimeter
   Q4112          No Change       Cymetra injectable             Cymetra, injectable, 1 cc
   Q4113          No Change       Graftjacket xpress             Graftjacket xpress, injectable, 1 cc
   Q4114          No Change       Integra flowable wound matri   Integra flowable wound matrix, injectable, 1 cc
   Q4115          No Change       Alloskin                       Alloskin, per square centimeter
   Q4116          No Change       Alloderm                       Alloderm, per square centimeter
   Q4117          No Change       Hyalomatrix                    Hyalomatrix, per square centimeter
   Q4118          No Change       Matristem micromatrix          Matristem micromatrix, 1 mg
   Q4119          No Change       Matristem wound matrix         Matristem wound matrix, per square centimeter
   Q4120          No Change       Matristem burn matrix          Matristem burn matrix, per square centimeter
   Q4121          No Change       Theraskin                      Theraskin, per square centimeter
   Q4122          No Change       Dermacell                      Dermacell, per square centimeter
   Q4123          No Change       Alloskin                       Alloskin rt, per square centimeter
   Q4124          No Change       Oasis tri-layer wound matrix   Oasis ultra tri-layer wound matrix, per square centimeter
   Q4125          No Change       Arthroflex                     Arthroflex, per square centimeter
   Q4126          No Change       Memoderm/derma/tranz/integup   Memoderm, dermaspan, tranzgraft or integuply, per square cent
   Q4127          No Change       Talymed                        Talymed, per square centimeter
   Q4128          No Change       Flexhd/allopatchhd/matrixhd    Flex hd, allopatch hd, or matrix hd, per square centimeter
   Q4129          No Change       Unite biomatrix                Unite biomatrix, per square centimeter
   Q4130          No Change       Strattice tm                   Strattice tm, per square centimeter
   Q4132          No Change       Grafix core, grafixpl core     Grafix core and grafixpl core, per square centimeter
   Q4134          No Change       Hmatrix                        Hmatrix, per square centimeter
   Q4135          No Change       Mediskin                       Mediskin, per square centimeter
   Q4136          No Change       Ezderm                         Ez-derm, per square centimeter
   Q4138          No Change       Biodfence dryflex, 1cm         Biodfence dryflex, per square centimeter
   Q4139          No Change       Amnio or biodmatrix, inj 1cc   Amniomatrix or biodmatrix, injectable, 1 cc
   Q4140          No Change       Biodfence 1cm                  Biodfence, per square centimeter
   Q4141          No Change       Alloskin ac, 1 cm              Alloskin ac, per square centimeter
   Q4142          No Change       Xcm biologic tiss matrix 1cm   Xcm biologic tissue matrix, per square centimeter
   Q4143          No Change       Repriza, 1cm                   Repriza, per square centimeter
   Q4145          No Change       Epifix, inj, 1mg               Epifix, injectable, 1 mg
   Q4146          No Change       Tensix, 1cm                    Tensix, per square centimeter
   Q4147          No Change       Architect ecm px fx 1 sq cm    Architect, architect px, or architect fx, extracellular matri
   Q4148          No Change       Neox neox rt or clarix cord    Neox cord 1k, neox cord rt, or clarix cord 1k, per square cen
   Q4149          No Change       Excellagen, 0.1 cc             Excellagen, 0.1 cc
   Q4150          No Change       Allowrap ds or dry 1 sq cm     Allowrap ds or dry, per square centimeter
   Q4151          No Change       Amnioband, guardian 1 sq cm    Amnioband or guardian, per square centimeter
   Q4152          No Change       Dermapure 1 square cm          Dermapure, per square centimeter
   Q4153          No Change       Dermavest, plurivest sq cm     Dermavest and plurivest, per square centimeter
   Q4154          No Change       Biovance 1 square cm           Biovance, per square centimeter
   Q4155          No Change       Neoxflo or clarixflo 1 mg      Neoxflo or clarixflo, 1 mg
   Q4156          No Change       Neox 100 or clarix 100         Neox 100 or clarix 100, per square centimeter
   Q4157          No Change       Revitalon 1 square cm          Revitalon, per square centimeter
   Q4158          No Change       Kerecis omega3, per sq cm      Kerecis omega3, per square centimeter
   Q4159          No Change       Affinity1 square cm            Affinity, per square centimeter
   Q4160          No Change       Nushield 1 square cm           Nushield, per square centimeter
   Q4161          No Change       Bio-connekt per square cm      Bio-connekt wound matrix, per square centimeter
   Q4162          No Change       Wndex flw, bioskn flw, 0.5cc   Woundex flow, bioskin flow, 0.5 cc
   Q4163          No Change       Woundex, bioskin, per sq cm    Woundex, bioskin, per square centimeter
   Q4164          No Change       Helicoll, per square cm        Helicoll, per square centimeter
   Q4165          No Change       Keramatrix, per square cm      Keramatrix, per square centimeter
   Q4166          No Change       Cytal, per square centimeter   Cytal, per square centimeter
   Q4167          No Change       Truskin, per sq centimeter     Truskin, per square centimeter
   Q4168          No Change       Amnioband, 1 mg                Amnioband, 1 mg
   Q4169          No Change       Artacent wound, per sq cm      Artacent wound, per square centimeter
   Q4170          No Change       Cygnus, per sq cm              Cygnus, per square centimeter
   Q4171          No Change       Interfyl, 1 mg                 Interfyl, 1 mg
   Q4173          No Change       Palingen or palingen xplus     Palingen or palingen xplus, per square centimeter
   Q4174          No Change       Palingen or promatrx           Palingen or promatrx, 0.36 mg per 0.25 cc
   Q4175          No Change       Miroderm                       Miroderm, per square centimeter
   Q4176          No Change       Neopatch, per sq centimeter    Neopatch, per square centimeter
   Q4177          No Change       Floweramnioflo, 0.1 cc         Floweramnioflo, 0.1 cc
   Q4178          No Change       Floweramniopatch, per sq cm    Floweramniopatch, per square centimeter
   Q4179          No Change       Flowerderm, per sq cm          Flowerderm, per square centimeter
   Q4180          No Change       Revita, per sq cm              Revita, per square centimeter
   Q4181          No Change       Amnio wound, per square cm     Amnio wound, per square centimeter
   Q4182          No Change       Transcyte, per sq centimeter   Transcyte, per square centimeter
   Q5001          No Change       Hospice or home hlth in home   Hospice or home health care provided in patient's home/reside
   Q5002          No Change       Hospice/home hlth in asst lv   Hospice or home health care provided in assisted living facil
   Q5003          No Change       Hospice in lt/non-skilled nf   Hospice care provided in nursing long term care facility (ltc
   Q5004          No Change       Hospice in snf                 Hospice care provided in skilled nursing facility (snf)
   Q5005          No Change       Hospice, inpatient hospital    Hospice care provided in inpatient hospital
   Q5006          No Change       Hospice in hospice facility    Hospice care provided in inpatient hospice facility
   Q5007          No Change       Hospice in ltch                Hospice care provided in long term care facility
   Q5008          No Change       Hospice in inpatient psych     Hospice care provided in inpatient psychiatric facility
   Q5009          No Change       Hospice/home hlth, place nos   Hospice or home health care provided in place not otherwise s
   Q5010          No Change       Hospice home care in hospice   Hospice home care provided in a hospice facility
   Q9951          No Change       Locm >= 400 mg/ml iodine,1ml   Low osmolar contrast material, 400 or greater mg/ml iodine co
   Q9953          No Change       Inj fe-based mr contrast,1ml   Injection, iron-based magnetic resonance contrast agent, per
   Q9954          No Change       Oral mr contrast, 100 ml       Oral magnetic resonance contrast agent, per 100 ml
   Q9955          No Change       Inj perflexane lip micros,ml   Injection, perflexane lipid microspheres, per ml
   Q9956          No Change       Inj octafluoropropane mic,ml   Injection, octafluoropropane microspheres, per ml
   Q9957          No Change       Inj perflutren lip micros,ml   Injection, perflutren lipid microspheres, per ml
   Q9958          No Change       Hocm <=149 mg/ml iodine, 1ml   High osmolar contrast material, up to 149 mg/ml iodine concen
   Q9959          No Change       Hocm 150-199mg/ml iodine,1ml   High osmolar contrast material, 150-199 mg/ml iodine concentr
   Q9960          No Change       Hocm 200-249mg/ml iodine,1ml   High osmolar contrast material, 200-249 mg/ml iodine concentr
   Q9961          No Change       Hocm 250-299mg/ml iodine,1ml   High osmolar contrast material, 250-299 mg/ml iodine concentr
   Q9962          No Change       Hocm 300-349mg/ml iodine,1ml   High osmolar contrast material, 300-349 mg/ml iodine concentr
   Q9963          No Change       Hocm 350-399mg/ml iodine,1ml   High osmolar contrast material, 350-399 mg/ml iodine concentr
   Q9964          No Change       Hocm>= 400mg/ml iodine, 1ml    High osmolar contrast material, 400 or greater mg/ml iodine c
   Q9965          No Change       Locm 100-199mg/ml iodine,1ml   Low osmolar contrast material, 100-199 mg/ml iodine concentra
   Q9966          No Change       Locm 200-299mg/ml iodine,1ml   Low osmolar contrast material, 200-299 mg/ml iodine concentra
   Q9967          No Change       Locm 300-399mg/ml iodine,1ml   Low osmolar contrast material, 300-399 mg/ml iodine concentra
   Q9968          No Change       Visualization adjunct          Injection, non-radioactive, non-contrast, visualization adjun
   Q9969          No Change       Non-heu tc-99m add-on/dose     Tc-99m from non-highly enriched uranium source, full cost rec
   Q9970          No Change       Inj ferric carboxymaltos 1mg   Injection, ferric carboxymaltose, 1mg
   Q9972          No Change       Epoetin beta esrd use          Injection, epoetin beta, 1 microgram, (for esrd on dialysis)
   Q9973          No Change       Epoetin beta non esrd          Injection, epoetin beta, 1 microgram, (non-esrd use)
   Q9974          No Change       Morphine epidural/intratheca   Injection, morphine sulfate, preservative-free for epidural o
   Q9975          No Change       Factor viii fc fusion recomb   Injection, factor viii fc fusion protein (recombinant), per i
   Q9976          No Change       Inj ferric pyrophosphate cit   Injection, ferric pyrophosphate citrate solution, 0.1 mg of i
   Q9977          No Change       Compounded drug noc            Compounded drug, not otherwise classified
   Q9978          No Change       Netupitant palonosetron oral   Netupitant 300 mg and palonosetron 0.5 mg
   Q9979          No Change       Injection, alemtuzumab         Injection, alemtuzumab, 1 mg
   Q9980          No Change       Genvisc, inj, 1mg              Hyaluronan or derivative, genvisc 850, for intra-articular in
   Q9981          No Change       Rolapitant, oral, 1mg          Rolapitant, oral, 1 mg
   Q9984          No Change       Kyleena, 19.5 mg               Levonorgestrel-releasing intrauterine contraceptive system (k
   Q9985          No Change       Inj hydroxyprogst capoat nos   Injection, hydroxyprogesterone caproate, not otherwise specif
   Q9986          No Change       Makena, 10 mg                  Injection, hydroxyprogesterone caproate, (makena), 10 mg
   Q9987          No Change       Pathogen test for platelets    Pathogen(s) test for platelets
   Q9988          No Change       Platelets, pathogen reduced    Platelets, pheresis, pathogen-reduced, each unit
   Q9989          No Change       Ustekinumab, iv inject,1 mg    Ustekinumab, for intravenous injection, 1 mg
   R0070          No Change       Transport portable x-ray       Transportation of portable x-ray equipment and personnel to h
   R0075          No Change       Transport port x-ray multipl   Transportation of portable x-ray equipment and personnel to h
   R0076          No Change       Transport portable ekg         Transportation of portable ekg to facility or location, per p
   S0012          No Change       Butorphanol tartrate, nasal    Butorphanol tartrate, nasal spray, 25 mg
   S0014          No Change       Tacrine hydrochloride, 10 mg   Tacrine hydrochloride, 10 mg
   S0017          No Change       Injection, aminocaproic acid   Injection, aminocaproic acid, 5 grams
   S0020          No Change       Injection, bupivicaine hydro   Injection, bupivicaine hydrochloride, 30 ml
   S0021          No Change       Injection, cefoperazone sod    Injection, cefoperazone sodium, 1 gram
   S0023          No Change       Injection, cimetidine hydroc   Injection, cimetidine hydrochloride, 300 mg
   S0028          No Change       Injection, famotidine, 20 mg   Injection, famotidine, 20 mg
   S0030          No Change       Injection, metronidazole       Injection, metronidazole, 500 mg
   S0032          No Change       Injection, nafcillin sodium    Injection, nafcillin sodium, 2 grams
   S0034          No Change       Injection, ofloxacin, 400 mg   Injection, ofloxacin, 400 mg
   S0039          No Change       Injection, sulfamethoxazole    Injection, sulfamethoxazole and trimethoprim, 10 ml
   S0040          No Change       Injection, ticarcillin disod   Injection, ticarcillin disodium and clavulanate potassium, 3.
   S0073          No Change       Injection, aztreonam, 500 mg   Injection, aztreonam, 500 mg
   S0074          No Change       Injection, cefotetan disodiu   Injection, cefotetan disodium, 500 mg
   S0077          No Change       Injection, clindamycin phosp   Injection, clindamycin phosphate, 300 mg
   S0078          No Change       Injection, fosphenytoin sodi   Injection, fosphenytoin sodium, 750 mg
   S0080          No Change       Injection, pentamidine iseth   Injection, pentamidine isethionate, 300 mg
   S0081          No Change       Injection, piperacillin sodi   Injection, piperacillin sodium, 500 mg
   S0088          No Change       Imatinib 100 mg                Imatinib, 100 mg
   S0090          No Change       Sildenafil citrate, 25 mg      Sildenafil citrate, 25 mg
   S0091          No Change       Granisetron 1mg                Granisetron hydrochloride, 1 mg (for circumstances falling un
   S0092          No Change       Hydromorphone 250 mg           Injection, hydromorphone hydrochloride, 250 mg (loading dose
   S0093          No Change       Morphine 500 mg                Injection, morphine sulfate, 500 mg (loading dose for infusio
   S0104          No Change       Zidovudine, oral, 100 mg       Zidovudine, oral, 100 mg
   S0106          No Change       Bupropion hcl sr 60 tablets    Bupropion hcl sustained release tablet, 150 mg, per bottle of
   S0108          No Change       Mercaptopurine 50 mg           Mercaptopurine, oral, 50 mg
   S0109          No Change       Methadone oral 5mg             Methadone, oral, 5 mg
   S0117          No Change       Tretinoin topical 5 g          Tretinoin, topical, 5 grams
   S0119          No Change       Ondansetron 4 mg               Ondansetron, oral, 4 mg (for circumstances falling under the
   S0122          No Change       Inj menotropins 75 iu          Injection, menotropins, 75 iu
   S0126          No Change       Inj follitropin alfa 75 iu     Injection, follitropin alfa, 75 iu
   S0128          No Change       Inj follitropin beta 75 iu     Injection, follitropin beta, 75 iu
   S0132          No Change       Inj ganirelix acetat 250 mcg   Injection, ganirelix acetate, 250 mcg
   S0136          No Change       Clozapine, 25 mg               Clozapine, 25 mg
   S0137          No Change       Didanosine, 25 mg              Didanosine (ddi), 25 mg
   S0138          No Change       Finasteride, 5 mg              Finasteride, 5 mg
   S0139          No Change       Minoxidil, 10 mg               Minoxidil, 10 mg
   S0140          No Change       Saquinavir, 200 mg             Saquinavir, 200 mg
   S0142          No Change       Colistimethate inh sol mg      Colistimethate sodium, inhalation solution administered throu
   S0144          No Change       Inj, propofol, 10 mg           Injection, propofol, 10 mg
   S0145          No Change       Peg interferon alfa-2a/180     Injection, pegylated interferon alfa-2a, 180 mcg per ml
   S0148          No Change       Peg interferon alfa-2b/10      Injection, pegylated interferon alfa-2b, 10 mcg
   S0155          No Change       Epoprostenol dilutant          Sterile dilutant for epoprostenol, 50 ml
   S0156          No Change       Exemestane, 25 mg              Exemestane, 25 mg
   S0157          No Change       Becaplermin gel 1%, 0.5 gm     Becaplermin gel 0.01%, 0.5 gm
   S0160          No Change       Dextroamphetamine              Dextroamphetamine sulfate, 5 mg
   S0164          No Change       Injection pantroprazole        Injection, pantoprazole sodium, 40 mg
   S0166          No Change       Inj olanzapine 2.5mg           Injection, olanzapine, 2.5 mg
   S0169          No Change       Calcitrol                      Calcitrol, 0.25 microgram
   S0170          No Change       Anastrozole 1 mg               Anastrozole, oral, 1 mg
   S0171          No Change       Bumetanide 0.5 mg              Injection, bumetanide, 0.5 mg
   S0172          No Change       Chlorambucil 2 mg              Chlorambucil, oral, 2 mg
   S0174          No Change       Dolasetron 50 mg               Dolasetron mesylate, oral 50 mg (for circumstances falling un
   S0175          No Change       Flutamide 125 mg               Flutamide, oral, 125 mg
   S0176          No Change       Hydroxyurea 500 mg             Hydroxyurea, oral, 500 mg
   S0177          No Change       Levamisole 50 mg               Levamisole hydrochloride, oral, 50 mg
   S0178          No Change       Lomustine 10 mg                Lomustine, oral, 10 mg
   S0179          No Change       Megestrol 20 mg                Megestrol acetate, oral, 20 mg
   S0182          No Change       Procarbazine, oral             Procarbazine hydrochloride, oral, 50 mg
   S0183          No Change       Prochlorperazine 5 mg          Prochlorperazine maleate, oral, 5 mg (for circumstances falli
   S0187          No Change       Tamoxifen 10 mg                Tamoxifen citrate, oral, 10 mg
   S0189          No Change       Testosterone pellet 75 mg      Testosterone pellet, 75 mg
   S0190          No Change       Mifepristone, oral, 200 mg     Mifepristone, oral, 200 mg
   S0191          No Change       Misoprostol, oral, 200 mcg     Misoprostol, oral, 200 mcg
   S0194          No Change       Vitamin suppl 100 caps         Dialysis/stress vitamin supplement, oral, 100 capsules
   S0195          No Change       Pneumo vaccine 5-9 yrs         Pneumococcal conjugate vaccine, polyvalent, intramuscular, fo
   S0197          No Change       Prenatal vitamins 30 day       Prenatal vitamins, 30-day supply
   S0199          No Change       Med abortion inc all ex drug   Medically induced abortion by oral ingestion of medication in
   S0201          No Change       Partial hospitalization serv   Partial hospitalization services, less than 24 hours, per die
   S0207          No Change       Paramedicintercep nonhospals   Paramedic intercept, non-hospital-based als service (non-volu
   S0208          No Change       Paramed intrcept nonvol        Paramedic intercept, hospital-based als service (non-voluntar
   S0209          No Change       Wc van mileage per mi          Wheelchair van, mileage, per mile
   S0215          No Change       Nonemerg transp mileage        Non-emergency transportation; mileage, per mile
   S0220          No Change       Medical conference by physic   Medical conference by a physician with interdisciplinary team
   S0221          No Change       Medical conference, 60 min     Medical conference by a physician with interdisciplinary team
   S0250          No Change       Comp geriatr assmt team        Comprehensive geriatric assessment and treatment planning per
   S0255          No Change       Hospice refer visit nonmd      Hospice referral visit (advising patient and family of care o
   S0257          No Change       End of life counseling         Counseling and discussion regarding advance directives or end
   S0260          No Change       H&p for surgery                History and physical (outpatient or office) related to surgic
   S0265          No Change       Genetic counsel 15 mins        Genetic counseling, under physician supervision, each 15 minu
   S0270          No Change       Home std case rate 30 days     Physician management of patient home care, standard monthly c
   S0271          No Change       Home hospice case 30 days      Physician management of patient home care, hospice monthly ca
   S0272          No Change       Home episodic case 30 days     Physician management of patient home care, episodic care mont
   S0273          No Change       Md home visit outside cap      Physician visit at member's home, outside of a capitation arr
   S0274          No Change       Nurse practr visit outs cap    Nurse practitioner visit at member's home, outside of a capit
   S0280          No Change       Medical home, initial plan     Medical home program, comprehensive care coordination and pla
   S0281          No Change       Medical home, maintenance      Medical home program, comprehensive care coordination and pla
   S0285          No Change       Cnslt before screen colonosc   Colonoscopy consultation performed prior to a screening colon
   S0302          No Change       Completed epsdt                Completed early periodic screening diagnosis and treatment (e
   S0310          No Change       Hospitalist visit              Hospitalist services (list separately in addition to code for
   S0311          No Change       Comp mgmt care coord adv ill   Comprehensive management and care coordination for advanced i
   S0315          No Change       Disease management program     Disease management program; initial assessment and initiation
   S0316          No Change       Follow-up/reassessment         Disease management program, follow-up/reassessment
   S0317          No Change       Disease mgmt per diem          Disease management program; per diem
   S0320          No Change       Rn telephone calls to dmp      Telephone calls by a registered nurse to a disease management
   S0340          No Change       Lifestyle mod 1st stage        Lifestyle modification program for management of coronary art
   S0341          No Change       Lifestyle mod 2 or 3 stage     Lifestyle modification program for management of coronary art
   S0342          No Change       Lifestyle mod 4th stage        Lifestyle modification program for management of coronary art
   S0353          No Change       Cancer treatmentplan initial   Treatment planning and care coordination management for cance
   S0354          No Change       Cancer treatment plan change   Treatment planning and care coordination management for cance
   S0390          No Change       Rout foot care per visit       Routine foot care; removal and/or trimming of corns, calluses
   S0395          No Change       Impression casting ft          Impression casting of a foot performed by a practitioner othe
   S0400          No Change       Global eswl kidney             Global fee for extracorporeal shock wave lithotripsy treatmen
   S0500          No Change       Dispos cont lens               Disposable contact lens, per lens
   S0504          No Change       Singl prscrp lens              Single vision prescription lens (safety, athletic, or sunglas
   S0506          No Change       Bifoc prscp lens               Bifocal vision prescription lens (safety, athletic, or sungla
   S0508          No Change       Trifoc prscrp lens             Trifocal vision prescription lens (safety, athletic, or sungl
   S0510          No Change       Non-prscrp lens                Non-prescription lens (safety, athletic, or sunglass), per le
   S0512          No Change       Daily cont lens                Daily wear specialty contact lens, per lens
   S0514          No Change       Color cont lens                Color contact lens, per lens
   S0515          No Change       Scleral lens liquid bandage    Scleral lens, liquid bandage device, per lens
   S0516          No Change       Safety frames                  Safety eyeglass frames
   S0518          No Change       Sunglass frames                Sunglasses frames
   S0580          No Change       Polycarb lens                  Polycarbonate lens (list this code in addition to the basic c
   S0581          No Change       Nonstnd lens                   Nonstandard lens (list this code in addition to the basic cod
   S0590          No Change       Misc integral lens serv        Integral lens service, miscellaneous services reported separa
   S0592          No Change       Comp cont lens eval            Comprehensive contact lens evaluation
   S0595          No Change       New lenses in pts old frame    Dispensing new spectacle lenses for patient supplied frame
   S0596          No Change       Phakic iol refractive error    Phakic intraocular lens for correction of refractive error
   S0601          No Change       Screening proctoscopy          Screening proctoscopy
   S0610          No Change       Annual gynecological examina   Annual gynecological examination, new patient
   S0612          No Change       Annual gynecological examina   Annual gynecological examination, established patient
   S0613          No Change       Ann breast exam                Annual gynecological examination; clinical breast examination
   S0618          No Change       Audiometry for hearing aid     Audiometry for hearing aid evaluation to determine the level
   S0620          No Change       Routine ophthalmological exa   Routine ophthalmological examination including refraction; ne
   S0621          No Change       Routine ophthalmological exa   Routine ophthalmological examination including refraction; es
   S0622          No Change       Phys exam for college          Physical exam for college, new or established patient (list s
   S0630          No Change       Removal of sutures             Removal of sutures; by a physician other than the physician w
   S0800          No Change       Laser in situ keratomileusis   Laser in situ keratomileusis (lasik)
   S0810          No Change       Photorefractive keratectomy    Photorefractive keratectomy (prk)
   S0812          No Change       Phototherap keratect           Phototherapeutic keratectomy (ptk)
   S1001          No Change       Deluxe item                    Deluxe item, patient aware (list in addition to code for basi
   S1002          No Change       Custom item                    Customized item (list in addition to code for basic item)
   S1015          No Change       Iv tubing extension set        Iv tubing extension set
   S1016          No Change       Non-pvc intravenous administ   Non-pvc (polyvinyl chloride) intravenous administration set,
   S1030          No Change       Gluc monitor purchase          Continuous noninvasive glucose monitoring device, purchase (f
   S1031          No Change       Gluc monitor rental            Continuous noninvasive glucose monitoring device, rental, inc
   S1034          No Change       Art pancreas system            Artificial pancreas device system (e.g., low glucose suspend
   S1035          No Change       Art pancreas inv disp sensor   Sensor; invasive (e.g., subcutaneous), disposable, for use wi
   S1036          No Change       Art pancreas ext transmitter   Transmitter; external, for use with artificial pancreas devic
   S1037          No Change       Art pancreas ext receiver      Receiver (monitor); external, for use with artificial pancrea
   S1040          No Change       Cranial remolding orthosis     Cranial remolding orthosis, pediatric, rigid, with soft inter
   S1090          No Change       Mometasone sinus implant       Mometasone furoate sinus implant, 370 micrograms
   S2053          No Change       Transplantation of small int   Transplantation of small intestine and liver allografts
   S2054          No Change       Transplantation of multivisc   Transplantation of multivisceral organs
   S2055          No Change       Harvesting of donor multivis   Harvesting of donor multivisceral organs, with preparation an
   S2060          No Change       Lobar lung transplantation     Lobar lung transplantation
   S2061          No Change       Donor lobectomy (lung)         Donor lobectomy (lung) for transplantation, living donor
   S2065          No Change       Simult panc kidn trans         Simultaneous pancreas kidney transplantation
   S2066          No Change       Breast gap flap reconst        Breast reconstruction with gluteal artery perforator (gap) fl
   S2067          No Change       Breast "stacked" diep/gap      Breast reconstruction of a single breast with "stacked" deep
   S2068          No Change       Breast diep or siea flap       Breast reconstruction with deep inferior epigastric perforato
   S2070          No Change       Cysto laser tx ureteral calc   Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with
   S2079          No Change       Lap esophagomyotomy            Laparoscopic esophagomyotomy (heller type)
   S2080          No Change       Laup                           Laser-assisted uvulopalatoplasty (laup)
   S2083          No Change       Adjustment gastric band        Adjustment of gastric band diameter via subcutaneous port by
   S2095          No Change       Transcath emboliz microspher   Transcatheter occlusion or embolization for tumor destruction
   S2102          No Change       Islet cell tissue transplant   Islet cell tissue transplant from pancreas; allogeneic
   S2103          No Change       Adrenal tissue transplant      Adrenal tissue transplant to brain
   S2107          No Change       Adoptive immunotherapy         Adoptive immunotherapy i.e. development of specific anti-tumo
   S2112          No Change       Knee arthroscp harv            Arthroscopy, knee, surgical for harvesting of cartilage (chon
   S2115          No Change       Periacetabular osteotomy       Osteotomy, periacetabular, with internal fixation
   S2117          No Change       Arthroereisis, subtalar        Arthroereisis, subtalar
   S2118          No Change       Total hip resurfacing          Metal-on-metal total hip resurfacing, including acetabular an
   S2120          No Change       Low density lipoprotein(ldl)   Low density lipoprotein (ldl) apheresis using heparin-induced
   S2140          No Change       Cord blood harvesting          Cord blood harvesting for transplantation, allogeneic
   S2142          No Change       Cord blood-derived stem-cell   Cord blood-derived stem-cell transplantation, allogeneic
   S2150          No Change       Bmt harv/transpl 28d pkg       Bone marrow or blood-derived stem cells (peripheral or umbili
   S2152          No Change       Solid organ transpl pkg        Solid organ(s), complete or segmental, single organ or combin
   S2202          No Change       Echosclerotherapy              Echosclerotherapy
   S2205          No Change       Minimally invasive direct co   Minimally invasive direct coronary artery bypass surgery invo
   S2206          No Change       Minimally invasive direct co   Minimally invasive direct coronary artery bypass surgery invo
   S2207          No Change       Minimally invasive direct co   Minimally invasive direct coronary artery bypass surgery invo
   S2208          No Change       Minimally invasive direct co   Minimally invasive direct coronary artery bypass surgery invo
   S2209          No Change       Minimally invasive direct co   Minimally invasive direct coronary artery bypass surgery invo
   S2225          No Change       Myringotomy laser-assist       Myringotomy, laser-assisted
   S2230          No Change       Implant semi-imp hear          Implantation of magnetic component of semi-implantable hearin
   S2235          No Change       Implant auditory brain imp     Implantation of auditory brain stem implant
   S2260          No Change       Induced abortion 17-24 weeks   Induced abortion, 17 to 24 weeks
   S2265          No Change       Induced abortion 25-28 wks     Induced abortion, 25 to 28 weeks
   S2266          No Change       Induced abortion 29-31 wks     Induced abortion, 29 to 31 weeks
   S2267          No Change       Induced abortion 32 or more    Induced abortion, 32 weeks or greater
   S2300          No Change       Arthroscopy, shoulder, surgi   Arthroscopy, shoulder, surgical; with thermally-induced capsu
   S2325          No Change       Hip core decompression         Hip core decompression
   S2340          No Change       Chemodenervation of abductor   Chemodenervation of abductor muscle(s) of vocal cord
   S2341          No Change       Chemodenerv adduct vocal       Chemodenervation of adductor muscle(s) of vocal cord
   S2342          No Change       Nasal endoscop po debrid       Nasal endoscopy for post-operative debridement following func
   S2348          No Change       Decompress disc rf lumbar      Decompression procedure, percutaneous, of nucleus pulposus of
   S2350          No Change       Diskectomy, anterior, with d   Diskectomy, anterior, with decompression of spinal cord and/o
   S2351          No Change       Diskectomy, anterior, with d   Diskectomy, anterior, with decompression of spinal cord and/o
   S2360          No Change       Vertebroplast cerv 1st         Percutaneous vertebroplasty, one vertebral body, unilateral o
   S2361          No Change       Vertebroplast cerv addl        Each additional cervical vertebral body (list separately in a
   S2400          No Change       Fetal surg congen hernia       Repair, congenital diaphragmatic hernia in the fetus using te
   S2401          No Change       Fetal surg urin trac obstr     Repair, urinary tract obstruction in the fetus, procedure per
   S2402          No Change       Fetal surg cong cyst malf      Repair, congenital cystic adenomatoid malformation in the fet
   S2403          No Change       Fetal surg pulmon sequest      Repair, extralobar pulmonary sequestration in the fetus, proc
   S2404          No Change       Fetal surg myelomeningo        Repair, myelomeningocele in the fetus, procedure performed in
   S2405          No Change       Fetal surg sacrococ teratoma   Repair of sacrococcygeal teratoma in the fetus, procedure per
   S2409          No Change       Fetal surg noc                 Repair, congenital malformation of fetus, procedure performed
   S2411          No Change       Fetoscop laser ther ttts       Fetoscopic laser therapy for treatment of twin-to-twin transf
   S2900          No Change       Robotic surgical system        Surgical techniques requiring use of robotic surgical system
   S3000          No Change       Bilat dil retinal exam         Diabetic indicator; retinal eye exam, dilated, bilateral
   S3005          No Change       Eval self-assess depression    Performance measurement, evaluation of patient self assessmen
   S3600          No Change       Stat lab                       Stat laboratory request (situations other than s3601)
   S3601          No Change       Stat lab home/nf               Emergency stat laboratory charge for patient who is homebound
   S3620          No Change       Newborn metabolic screening    Newborn metabolic screening panel, includes test kit, postage
   S3630          No Change       Eosinophil blood count         Eosinophil count, blood, direct
   S3645          No Change       Hiv-1 antibody testing of or   Hiv-1 antibody testing of oral mucosal transudate
   S3650          No Change       Saliva test, hormone level;    Saliva test, hormone level; during menopause
   S3652          No Change       Saliva test, hormone level;    Saliva test, hormone level; to assess preterm labor risk
   S3655          No Change       Antisperm antibodies test      Antisperm antibodies test (immunobead)
   S3708          No Change       Gastrointestinal fat absorpt   Gastrointestinal fat absorption study
   S3721          No Change       Pca3 testing                   Prostate cancer antigen 3 (pca3) testing
   S3722          No Change       Dose optimization auc - 5fu    Dose optimization by area under the curve (auc) analysis, for
   S3800          No Change       Genetic testing als            Genetic testing for amyotrophic lateral sclerosis (als)
   S3840          No Change       Dna analysis ret-oncogene      Dna analysis for germline mutations of the ret proto-oncogene
   S3841          No Change       Gene test retinoblastoma       Genetic testing for retinoblastoma
   S3842          No Change       Gene test hippel-lindau        Genetic testing for von hippel-lindau disease
   S3844          No Change       Dna analysis deafness          Dna analysis of the connexin 26 gene (gjb2) for susceptibilit
   S3845          No Change       Gene test alpha-thalassemia    Genetic testing for alpha-thalassemia
   S3846          No Change       Gene test beta-thalassemia     Genetic testing for hemoglobin e beta-thalassemia
   S3849          No Change       Gene test niemann-pick         Genetic testing for niemann-pick disease
   S3850          No Change       Gene test sickle cell          Genetic testing for sickle cell anemia
   S3852          No Change       Dna analysis apoe alzheimer    Dna analysis for apoe epsilon 4 allele for susceptibility to
   S3853          No Change       Gene test myo musclr dyst      Genetic testing for myotonic muscular dystrophy
   S3854          No Change       Gene profile panel breast      Gene expression profiling panel for use in the management of
   S3855          No Change       Gene test presenilin-1 gene    Genetic testing for detection of mutations in the presenilin
   S3861          No Change       Genetic test brugada           Genetic testing, sodium channel, voltage-gated, type v, alpha
   S3865          No Change       Comp genet test hyp cardiomy   Comprehensive gene sequence analysis for hypertrophic cardiom
   S3866          No Change       Spec gene test hyp cardiomy    Genetic analysis for a specific gene mutation for hypertrophi
   S3870          No Change       Cgh test developmental delay   Comparative genomic hybridization (cgh) microarray testing fo
   S3890          No Change       Fecal dna analysis             Dna analysis, fecal, for colorectal cancer screening
   S3900          No Change       Surface emg                    Surface electromyography (emg)
   S3902          No Change       Ballistocardiogram             Ballistocardiogram
   S3904          No Change       Masters two step               Masters two step
   S4005          No Change       Interim labor facility globa   Interim labor facility global (labor occurring but not result
   S4011          No Change       Ivf package                    In vitro fertilization; including but not limited to identifi
   S4013          No Change       Compl gift case rate           Complete cycle, gamete intrafallopian transfer (gift), case r
   S4014          No Change       Compl zift case rate           Complete cycle, zygote intrafallopian transfer (zift), case r
   S4015          No Change       Complete ivf nos case rate     Complete in vitro fertilization cycle, not otherwise specifie
   S4016          No Change       Frozen ivf case rate           Frozen in vitro fertilization cycle, case rate
   S4017          No Change       Ivf canc a stim case rate      Incomplete cycle, treatment cancelled prior to stimulation, c
   S4018          No Change       F emb trns canc case rate      Frozen embryo transfer procedure cancelled before transfer, c
   S4020          No Change       Ivf canc a aspir case rate     In vitro fertilization procedure cancelled before aspiration,
   S4021          No Change       Ivf canc p aspir case rate     In vitro fertilization procedure cancelled after aspiration,
   S4022          No Change       Asst oocyte fert case rate     Assisted oocyte fertilization, case rate
   S4023          No Change       Incompl donor egg case rate    Donor egg cycle, incomplete, case rate
   S4025          No Change       Donor serv ivf case rate       Donor services for in vitro fertilization (sperm or embryo),
   S4026          No Change       Procure donor sperm            Procurement of donor sperm from sperm bank
   S4027          No Change       Store prev froz embryos        Storage of previously frozen embryos
   S4028          No Change       Microsurg epi sperm asp        Microsurgical epididymal sperm aspiration (mesa)
   S4030          No Change       Sperm procure init visit       Sperm procurement and cryopreservation services; initial visi
   S4031          No Change       Sperm procure subs visit       Sperm procurement and cryopreservation services; subsequent v
   S4035          No Change       Stimulated iui case rate       Stimulated intrauterine insemination (iui), case rate
   S4037          No Change       Cryo embryo transf case rate   Cryopreserved embryo transfer, case rate
   S4040          No Change       Monit store cryo embryo 30 d   Monitoring and storage of cryopreserved embryos, per 30 days
   S4042          No Change       Ovulation mgmt per cycle       Management of ovulation induction (interpretation of diagnost
   S4981          No Change       Insert levonorgestrel ius      Insertion of levonorgestrel-releasing intrauterine system
   S4989          No Change       Contracept iud                 Contraceptive intrauterine device (e.g., progestacert iud), i
   S4990          No Change       Nicotine patch legend          Nicotine patches, legend
   S4991          No Change       Nicotine patch nonlegend       Nicotine patches, non-legend
   S4993          No Change       Contraceptive pills for bc     Contraceptive pills for birth control
   S4995          No Change       Smoking cessation gum          Smoking cessation gum
   S5000          No Change       Prescription drug, generic     Prescription drug, generic
   S5001          No Change       Prescription drug,brand name   Prescription drug, brand name
   S5010          No Change       5% dextrose and 0.45% saline   5% dextrose and 0.45% normal saline, 1000 ml
   S5011          No Change       5% dextrose in lactated ring   5% dextrose in lactated ringer's, 1000 ml
   S5012          No Change       5% dextrose with potassium     5% dextrose with potassium chloride, 1000 ml
   S5013          No Change       5%dextrose/0.45%saline1000ml   5% dextrose/0.45% normal saline with potassium chloride and m
   S5014          No Change       D5w/0.45ns w kcl and mgs04     5% dextrose/0.45% normal saline with potassium chloride and m
   S5035          No Change       Hit routine device maint       Home infusion therapy, routine service of infusion device (e.
   S5036          No Change       Hit device repair              Home infusion therapy, repair of infusion device (e.g., pump
   S5100          No Change       Adult daycare services 15min   Day care services, adult; per 15 minutes
   S5101          No Change       Adult day care per half day    Day care services, adult; per half day
   S5102          No Change       Adult day care per diem        Day care services, adult; per diem
   S5105          No Change       Centerbased day care perdiem   Day care services, center-based; services not included in pro
   S5108          No Change       Homecare train pt 15 min       Home care training to home care client, per 15 minutes
   S5109          No Change       Homecare train pt session      Home care training to home care client, per session
   S5110          No Change       Family homecare training 15m   Home care training, family; per 15 minutes
   S5111          No Change       Family homecare train/sessio   Home care training, family; per session
   S5115          No Change       Nonfamily homecare train/15m   Home care training, non-family; per 15 minutes
   S5116          No Change       Nonfamily hc train/session     Home care training, non-family; per session
   S5120          No Change       Chore services per 15 min      Chore services; per 15 minutes
   S5121          No Change       Chore services per diem        Chore services; per diem
   S5125          No Change       Attendant care service /15m    Attendant care services; per 15 minutes
   S5126          No Change       Attendant care service /diem   Attendant care services; per diem
   S5130          No Change       Homaker service nos per 15m    Homemaker service, nos; per 15 minutes
   S5131          No Change       Homemaker service nos /diem    Homemaker service, nos; per diem
   S5135          No Change       Adult companioncare per 15m    Companion care, adult (e.g., iadl/adl); per 15 minutes
   S5136          No Change       Adult companioncare per diem   Companion care, adult (e.g., iadl/adl); per diem
   S5140          No Change       Adult foster care per diem     Foster care, adult; per diem
   S5141          No Change       Adult foster care per month    Foster care, adult; per month
   S5145          No Change       Child fostercare th per diem   Foster care, therapeutic, child; per diem
   S5146          No Change       Ther fostercare child /month   Foster care, therapeutic, child; per month
   S5150          No Change       Unskilled respite care /15m    Unskilled respite care, not hospice; per 15 minutes
   S5151          No Change       Unskilled respitecare /diem    Unskilled respite care, not hospice; per diem
   S5160          No Change       Emer response sys instal&tst   Emergency response system; installation and testing
   S5161          No Change       Emer rspns sys serv permonth   Emergency response system; service fee, per month (excludes i
   S5162          No Change       Emer rspns system purchase     Emergency response system; purchase only
   S5165          No Change       Home modifications per serv    Home modifications; per service
   S5170          No Change       Homedelivered prepared meal    Home delivered meals, including preparation; per meal
   S5175          No Change       Laundry serv,ext,prof,/order   Laundry service, external, professional; per order
   S5180          No Change       Hh respiratory thrpy in eval   Home health respiratory therapy, initial evaluation
   S5181          No Change       Hh respiratory thrpy nos/day   Home health respiratory therapy, nos, per diem
   S5185          No Change       Med reminder serv per month    Medication reminder service, non-face-to-face; per month
   S5190          No Change       Wellness assessment by nonph   Wellness assessment, performed by non-physician
   S5199          No Change       Personal care item nos each    Personal care item, nos, each
   S5497          No Change       Hit cath care noc              Home infusion therapy, catheter care / maintenance, not other
   S5498          No Change       Hit simple cath care           Home infusion therapy, catheter care / maintenance, simple (s
   S5501          No Change       Hit complex cath care          Home infusion therapy, catheter care / maintenance, complex (
   S5502          No Change       Hit interim cath care          Home infusion therapy, catheter care / maintenance, implanted
   S5517          No Change       Hit declotting kit             Home infusion therapy, all supplies necessary for restoration
   S5518          No Change       Hit cath repair kit            Home infusion therapy, all supplies necessary for catheter re
   S5520          No Change       Hit picc insert kit            Home infusion therapy, all supplies (including catheter) nece
   S5521          No Change       Hit midline cath insert kit    Home infusion therapy, all supplies (including catheter) nece
   S5522          No Change       Hit picc insert no supp        Home infusion therapy, insertion of peripherally inserted cen
   S5523          No Change       Hip midline cath insert kit    Home infusion therapy, insertion of midline venous catheter,
   S5550          No Change       Insulin rapid 5 u              Insulin, rapid onset, 5 units
   S5551          No Change       Insulin most rapid 5 u         Insulin, most rapid onset (lispro or aspart); 5 units
   S5552          No Change       Insulin intermed 5 u           Insulin, intermediate acting (nph or lente); 5 units
   S5553          No Change       Insulin long acting 5 u        Insulin, long acting; 5 units
   S5560          No Change       Insulin reuse pen 1.5 ml       Insulin delivery device, reusable pen; 1.5 ml size
   S5561          No Change       Insulin reuse pen 3 ml         Insulin delivery device, reusable pen; 3 ml size
   S5565          No Change       Insulin cartridge 150 u        Insulin cartridge for use in insulin delivery device other th
   S5566          No Change       Insulin cartridge 300 u        Insulin cartridge for use in insulin delivery device other th
   S5570          No Change       Insulin dispos pen 1.5 ml      Insulin delivery device, disposable pen (including insulin);
   S5571          No Change       Insulin dispos pen 3 ml        Insulin delivery device, disposable pen (including insulin);
   S8030          No Change       Tantalum ring application      Scleral application of tantalum ring(s) for localization of l
   S8032          No Change       Low dose ct lung screening     Low-dose computed tomography for lung cancer screening
   S8035          No Change       Magnetic source imaging        Magnetic source imaging
   S8037          No Change       Mrcp                           Magnetic resonance cholangiopancreatography (mrcp)
   S8040          No Change       Topographic brain mapping      Topographic brain mapping
   S8042          No Change       Mri low field                  Magnetic resonance imaging (mri), low-field
   S8055          No Change       Us guidance fetal reduct       Ultrasound guidance for multifetal pregnancy reduction(s), te
   S8080          No Change       Scintimammography              Scintimammography (radioimmunoscintigraphy of the breast), un
   S8085          No Change       Fluorine-18 fluorodeoxygluco   Fluorine-18 fluorodeoxyglucose (f-18 fdg) imaging using dual-
   S8092          No Change       Electron beam computed tomog   Electron beam computed tomography (also known as ultrafast ct
   S8096          No Change       Portable peak flow meter       Portable peak flow meter
   S8097          No Change       Asthma kit                     Asthma kit (including but not limited to portable peak expira
   S8100          No Change       Spacer without mask            Holding chamber or spacer for use with an inhaler or nebulize
   S8101          No Change       Spacer with mask               Holding chamber or spacer for use with an inhaler or nebulize
   S8110          No Change       Peak expiratory flow rate (p   Peak expiratory flow rate (physician services)
   S8120          No Change       O2 contents gas cubic ft       Oxygen contents, gaseous, 1 unit equals 1 cubic foot
   S8121          No Change       O2 contents liquid lb          Oxygen contents, liquid, 1 unit equals 1 pound
   S8130          No Change       Interferential stim 2 chan     Interferential current stimulator, 2 channel
   S8131          No Change       Interferential stim 4 chan     Interferential current stimulator, 4 channel
   S8185          No Change       Flutter device                 Flutter device
   S8186          No Change       Swivel adaptor                 Swivel adapter
   S8189          No Change       Trach supply noc               Tracheostomy supply, not otherwise classified
   S8210          No Change       Mucus trap                     Mucus trap
   S8262          No Change       Mandib ortho repos device      Mandibular orthopedic repositioning device, each
   S8265          No Change       Haberman feeder                Haberman feeder for cleft lip/palate
   S8270          No Change       Enuresis alarm                 Enuresis alarm, using auditory buzzer and/or vibration device
   S8301          No Change       Infect control supplies nos    Infection control supplies, not otherwise specified
   S8415          No Change       Supplies for home delivery     Supplies for home delivery of infant
   S8420          No Change       Custom gradient sleev/glov     Gradient pressure aid (sleeve and glove combination), custom
   S8421          No Change       Ready gradient sleev/glov      Gradient pressure aid (sleeve and glove combination), ready m
   S8422          No Change       Custom grad sleeve med         Gradient pressure aid (sleeve), custom made, medium weight
   S8423          No Change       Custom grad sleeve heavy       Gradient pressure aid (sleeve), custom made, heavy weight
   S8424          No Change       Ready gradient sleeve          Gradient pressure aid (sleeve), ready made
   S8425          No Change       Custom grad glove med          Gradient pressure aid (glove), custom made, medium weight
   S8426          No Change       Custom grad glove heavy        Gradient pressure aid (glove), custom made, heavy weight
   S8427          No Change       Ready gradient glove           Gradient pressure aid (glove), ready made
   S8428          No Change       Ready gradient gauntlet        Gradient pressure aid (gauntlet), ready made
   S8429          No Change       Gradient pressure wrap         Gradient pressure exterior wrap
   S8430          No Change       Padding for comprssn bdg       Padding for compression bandage, roll
   S8431          No Change       Compression bandage            Compression bandage, roll
   S8450          No Change       Splint digit                   Splint, prefabricated, digit (specify digit by use of modifie
   S8451          No Change       Splint wrist or ankle          Splint, prefabricated, wrist or ankle
   S8452          No Change       Splint elbow                   Splint, prefabricated, elbow
   S8460          No Change       Camisole post-mast             Camisole, post-mastectomy
   S8490          No Change       100 insulin syringes           Insulin syringes (100 syringes, any size)
   S8930          No Change       Auricular electrostimulation   Electrical stimulation of auricular acupuncture points; each
   S8940          No Change       Hippotherapy per session       Equestrian/hippotherapy, per session
   S8948          No Change       Low-level laser trmt 15 min    Application of a modality (requiring constant provider attend
   S8950          No Change       Complex lymphedema therapy,    Complex lymphedema therapy, each 15 minutes
   S8990          No Change       Pt or manip for maint          Physical or manipulative therapy performed for maintenance ra
   S8999          No Change       Resuscitation bag              Resuscitation bag (for use by patient on artificial respirati
   S9001          No Change       Home uterine monitor with or   Home uterine monitor with or without associated nursing servi
   S9007          No Change       Ultrafiltration monitor        Ultrafiltration monitor
   S9015          No Change       Automated eeg monitoring       Automated eeg monitoring
   S9024          No Change       Paranasal sinus ultrasound     Paranasal sinus ultrasound
   S9025          No Change       Omnicardiogram/cardiointegra   Omnicardiogram/cardiointegram
   S9034          No Change       Eswl for gallstones            Extracorporeal shockwave lithotripsy for gall stones (if perf
   S9055          No Change       Procuren or other growth fac   Procuren or other growth factor preparation to promote wound
   S9056          No Change       Coma stimulation per diem      Coma stimulation per diem
   S9061          No Change       Medical supplies and equipme   Home administration of aerosolized drug therapy (e.g., pentam
   S9083          No Change       Urgent care center global      Global fee urgent care centers
   S9088          No Change       Services provided in urgent    Services provided in an urgent care center (list in addition
   S9090          No Change       Vertebral axial decompressio   Vertebral axial decompression, per session
   S9097          No Change       Home visit wound care          Home visit for wound care
   S9098          No Change       Home phototherapy visit        Home visit, phototherapy services (e.g., bili-lite), includin
   S9110          No Change       Telemonitoring/home per mnth   Telemonitoring of patient in their home, including all necess
   S9117          No Change       Back school visit              Back school, per visit
   S9122          No Change       Home health aide or certifie   Home health aide or certified nurse assistant, providing care
   S9123          No Change       Nursing care in home rn        Nursing care, in the home; by registered nurse, per hour (use
   S9124          No Change       Nursing care, in the home; b   Nursing care, in the home; by licensed practical nurse, per h
   S9125          No Change       Respite care, in the home, p   Respite care, in the home, per diem
   S9126          No Change       Hospice care, in the home, p   Hospice care, in the home, per diem
   S9127          No Change       Social work visit, in the ho   Social work visit, in the home, per diem
   S9128          No Change       Speech therapy, in the home,   Speech therapy, in the home, per diem
   S9129          No Change       Occupational therapy, in the   Occupational therapy, in the home, per diem
   S9131          No Change       Pt in the home per diem        Physical therapy; in the home, per diem
   S9140          No Change       Diabetic management program,   Diabetic management program, follow-up visit to non-md provid
   S9141          No Change       Diabetic management program,   Diabetic management program, follow-up visit to md provider
   S9145          No Change       Insulin pump initiation        Insulin pump initiation, instruction in initial use of pump (
   S9150          No Change       Evaluation by ocularist        Evaluation by ocularist
   S9152          No Change       Speech therapy, re-eval        Speech therapy, re-evaluation
   S9208          No Change       Home mgmt preterm labor        Home management of preterm labor, including administrative se
   S9209          No Change       Home mgmt pprom                Home management of preterm premature rupture of membranes (pp
   S9211          No Change       Home mgmt gest hypertension    Home management of gestational hypertension, includes adminis
   S9212          No Change       Hm postpar hyper per diem      Home management of postpartum hypertension, includes administ
   S9213          No Change       Hm preeclamp per diem          Home management of preeclampsia, includes administrative serv
   S9214          No Change       Hm gest dm per diem            Home management of gestational diabetes, includes administrat
   S9325          No Change       Hit pain mgmt per diem         Home infusion therapy, pain management infusion; administrati
   S9326          No Change       Hit cont pain per diem         Home infusion therapy, continuous (twenty-four hours or more)
   S9327          No Change       Hit int pain per diem          Home infusion therapy, intermittent (less than twenty-four ho
   S9328          No Change       Hit pain imp pump diem         Home infusion therapy, implanted pump pain management infusio
   S9329          No Change       Hit chemo per diem             Home infusion therapy, chemotherapy infusion; administrative
   S9330          No Change       Hit cont chem diem             Home infusion therapy, continuous (twenty-four hours or more)
   S9331          No Change       Hit intermit chemo diem        Home infusion therapy, intermittent (less than twenty-four ho
   S9335          No Change       Ht hemodialysis diem           Home therapy, hemodialysis; administrative services, professi
   S9336          No Change       Hit cont anticoag diem         Home infusion therapy, continuous anticoagulant infusion ther
   S9338          No Change       Hit immunotherapy diem         Home infusion therapy, immunotherapy, administrative services
   S9339          No Change       Hit periton dialysis diem      Home therapy; peritoneal dialysis, administrative services, p
   S9340          No Change       Hit enteral per diem           Home therapy; enteral nutrition; administrative services, pro
   S9341          No Change       Hit enteral grav diem          Home therapy; enteral nutrition via gravity; administrative s
   S9342          No Change       Hit enteral pump diem          Home therapy; enteral nutrition via pump; administrative serv
   S9343          No Change       Hit enteral bolus nurs         Home therapy; enteral nutrition via bolus; administrative ser
   S9345          No Change       Hit anti-hemophil diem         Home infusion therapy, anti-hemophilic agent infusion therapy
   S9346          No Change       Hit alpha-1-proteinas diem     Home infusion therapy, alpha-1-proteinase inhibitor (e.g., pr
   S9347          No Change       Hit longterm infusion diem     Home infusion therapy, uninterrupted, long-term, controlled r
   S9348          No Change       Hit sympathomim diem           Home infusion therapy, sympathomimetic/inotropic agent infusi
   S9349          No Change       Hit tocolysis diem             Home infusion therapy, tocolytic infusion therapy; administra
   S9351          No Change       Hit cont antiemetic diem       Home infusion therapy, continuous or intermittent anti-emetic
   S9353          No Change       Hit cont insulin diem          Home infusion therapy, continuous insulin infusion therapy; a
   S9355          No Change       Hit chelation diem             Home infusion therapy, chelation therapy; administrative serv
   S9357          No Change       Hit enzyme replace diem        Home infusion therapy, enzyme replacement intravenous therapy
   S9359          No Change       Hit anti-tnf per diem          Home infusion therapy, anti-tumor necrosis factor intravenous
   S9361          No Change       Hit diuretic infus diem        Home infusion therapy, diuretic intravenous therapy; administ
   S9363          No Change       Hit anti-spasmotic diem        Home infusion therapy, anti-spasmotic therapy; administrative
   S9364          No Change       Hit tpn total diem             Home infusion therapy, total parenteral nutrition (tpn); admi
   S9365          No Change       Hit tpn 1 liter diem           Home infusion therapy, total parenteral nutrition (tpn); one
   S9366          No Change       Hit tpn 2 liter diem           Home infusion therapy, total parenteral nutrition (tpn); more
   S9367          No Change       Hit tpn 3 liter diem           Home infusion therapy, total parenteral nutrition (tpn); more
   S9368          No Change       Hit tpn over 3l diem           Home infusion therapy, total parenteral nutrition (tpn); more
   S9370          No Change       Ht inj antiemetic diem         Home therapy, intermittent anti-emetic injection therapy; adm
   S9372          No Change       Ht inj anticoag diem           Home therapy; intermittent anticoagulant injection therapy (e
   S9373          No Change       Hit hydra total diem           Home infusion therapy, hydration therapy; administrative serv
   S9374          No Change       Hit hydra 1 liter diem         Home infusion therapy, hydration therapy; one liter per day,
   S9375          No Change       Hit hydra 2 liter diem         Home infusion therapy, hydration therapy; more than one liter
   S9376          No Change       Hit hydra 3 liter diem         Home infusion therapy, hydration therapy; more than two liter
   S9377          No Change       Hit hydra over 3l diem         Home infusion therapy, hydration therapy; more than three lit
   S9379          No Change       Hit noc per diem               Home infusion therapy, infusion therapy, not otherwise classi
   S9381          No Change       Hit high risk/escort           Delivery or service to high risk areas requiring escort or ex
   S9401          No Change       Anticoag clinic per session    Anticoagulation clinic, inclusive of all services except labo
   S9430          No Change       Pharmacy comp/disp serv        Pharmacy compounding and dispensing services
   S9433          No Change       Medical food oral 100% nutr    Medical food nutritionally complete, administered orally, pro
   S9434          No Change       Mod solid food suppl           Modified solid food supplements for inborn errors of metaboli
   S9435          No Change       Medical foods for inborn err   Medical foods for inborn errors of metabolism
   S9436          No Change       Lamaze class                   Childbirth preparation/lamaze classes, non-physician provider
   S9437          No Change       Childbirth refresher class     Childbirth refresher classes, non-physician provider, per ses
   S9438          No Change       Cesarean birth class           Cesarean birth classes, non-physician provider, per session
   S9439          No Change       Vbac class                     Vbac (vaginal birth after cesarean) classes, non-physician pr
   S9441          No Change       Asthma education               Asthma education, non-physician provider, per session
   S9442          No Change       Birthing class                 Birthing classes, non-physician provider, per session
   S9443          No Change       Lactation class                Lactation classes, non-physician provider, per session
   S9444          No Change       Parenting class                Parenting classes, non-physician provider, per session
   S9445          No Change       Pt education noc individ       Patient education, not otherwise classified, non-physician pr
   S9446          No Change       Pt education noc group         Patient education, not otherwise classified, non-physician pr
   S9447          No Change       Infant safety class            Infant safety (including cpr) classes, non-physician provider
   S9449          No Change       Weight mgmt class              Weight management classes, non-physician provider, per sessio
   S9451          No Change       Exercise class                 Exercise classes, non-physician provider, per session
   S9452          No Change       Nutrition class                Nutrition classes, non-physician provider, per session
   S9453          No Change       Smoking cessation class        Smoking cessation classes, non-physician provider, per sessio
   S9454          No Change       Stress mgmt class              Stress management classes, non-physician provider, per sessio
   S9455          No Change       Diabetic management program,   Diabetic management program, group session
   S9460          No Change       Diabetic management program,   Diabetic management program, nurse visit
   S9465          No Change       Diabetic management program,   Diabetic management program, dietitian visit
   S9470          No Change       Nutritional counseling, diet   Nutritional counseling, dietitian visit
   S9472          No Change       Cardiac rehabilitation progr   Cardiac rehabilitation program, non-physician provider, per d
   S9473          No Change       Pulmonary rehabilitation pro   Pulmonary rehabilitation program, non-physician provider, per
   S9474          No Change       Enterostomal therapy by a re   Enterostomal therapy by a registered nurse certified in enter
   S9475          No Change       Ambulatory setting substance   Ambulatory setting substance abuse treatment or detoxificatio
   S9476          No Change       Vestibular rehab per diem      Vestibular rehabilitation program, non-physician provider, pe
   S9480          No Change       Intensive outpatient psychia   Intensive outpatient psychiatric services, per diem
   S9482          No Change       Family stabilization 15 min    Family stabilization services, per 15 minutes
   S9484          No Change       Crisis intervention per hour   Crisis intervention mental health services, per hour
   S9485          No Change       Crisis intervention mental h   Crisis intervention mental health services, per diem
   S9490          No Change       Hit corticosteroid/diem        Home infusion therapy, corticosteroid infusion; administrativ
   S9494          No Change       Hit antibiotic total diem      Home infusion therapy, antibiotic, antiviral, or antifungal t
   S9497          No Change       Hit antibiotic q3h diem        Home infusion therapy, antibiotic, antiviral, or antifungal t
   S9500          No Change       Hit antibiotic q24h diem       Home infusion therapy, antibiotic, antiviral, or antifungal t
   S9501          No Change       Hit antibiotic q12h diem       Home infusion therapy, antibiotic, antiviral, or antifungal t
   S9502          No Change       Hit antibiotic q8h diem        Home infusion therapy, antibiotic, antiviral, or antifungal t
   S9503          No Change       Hit antibiotic q6h diem        Home infusion therapy, antibiotic, antiviral, or antifungal;
   S9504          No Change       Hit antibiotic q4h diem        Home infusion therapy, antibiotic, antiviral, or antifungal;
   S9529          No Change       Venipuncture home/snf          Routine venipuncture for collection of specimen(s), single ho
   S9537          No Change       Ht hem horm inj diem           Home therapy; hematopoietic hormone injection therapy (e.g.,
   S9538          No Change       Hit blood products diem        Home transfusion of blood product(s); administrative services
   S9542          No Change       Ht inj noc per diem            Home injectable therapy, not otherwise classified, including
   S9558          No Change       Ht inj growth horm diem        Home injectable therapy; growth hormone, including administra
   S9559          No Change       Hit inj interferon diem        Home injectable therapy, interferon, including administrative
   S9560          No Change       Ht inj hormone diem            Home injectable therapy; hormonal therapy (e.g.; leuprolide,
   S9562          No Change       Ht inj palivizumab diem        Home injectable therapy, palivizumab, including administrativ
   S9590          No Change       Ht irrigation diem             Home therapy, irrigation therapy (e.g., sterile irrigation of
   S9810          No Change       Ht pharm per hour              Home therapy; professional pharmacy services for provision of
   S9900          No Change       Christian sci pract visit      Services by a journal-listed christian science practitioner f
   S9901          No Change       Christian sci nurse visit      Services by a journal-listed christian science nurse, per hou
   S9960          No Change       Air ambulanc nonemerg fixed    Ambulance service, conventional air service, nonemergency tra
   S9961          No Change       Air ambulan nonemerg rotary    Ambulance service, conventional air service, nonemergency tra
   S9970          No Change       Health club membership yr      Health club membership, annual
   S9975          No Change       Transplant related per diem    Transplant related lodging, meals and transportation, per die
   S9976          No Change       Lodging per diem               Lodging, per diem, not otherwise classified
   S9977          No Change       Meals per diem                 Meals, per diem, not otherwise specified
   S9981          No Change       Med record copy admin          Medical records copying fee, administrative
   S9982          No Change       Med record copy per page       Medical records copying fee, per page
   S9986          No Change       Not medically necessary svc    Not medically necessary service (patient is aware that servic
   S9988          No Change       Serv part of phase i trial     Services provided as part of a phase i clinical trial
   S9989          No Change       Services outside us            Services provided outside of the united states of america (li
   S9990          No Change       Services provided as part of   Services provided as part of a phase ii clinical trial
   S9991          No Change       Services provided as part of   Services provided as part of a phase iii clinical trial
   S9992          No Change       Transportation costs to and    Transportation costs to and from trial location and local tra
   S9994          No Change       Lodging costs (e.g. hotel ch   Lodging costs (e.g., hotel charges) for clinical trial partic
   S9996          No Change       Meals for clinical trial par   Meals for clinical trial participant and one caregiver/compan
   S9999          No Change       Sales tax                      Sales tax
   T1000          No Change       Private duty/independent nsg   Private duty / independent nursing service(s) - licensed, up
   T1001          No Change       Nursing assessment/evaluatn    Nursing assessment / evaluation
   T1002          No Change       Rn services up to 15 minutes   Rn services, up to 15 minutes
   T1003          No Change       Lpn/lvn services up to 15min   Lpn/lvn services, up to 15 minutes
   T1004          No Change       Nsg aide service up to 15min   Services of a qualified nursing aide, up to 15 minutes
   T1005          No Change       Respite care service 15 min    Respite care services, up to 15 minutes
   T1006          No Change       Family/couple counseling       Alcohol and/or substance abuse services, family/couple counse
   T1007          No Change       Treatment plan development     Alcohol and/or substance abuse services, treatment plan devel
   T1009          No Change       Child sitting services         Child sitting services for children of the individual receivi
   T1010          No Change       Meals when receive services    Meals for individuals receiving alcohol and/or substance abus
   T1012          No Change       Alcohol/substance abuse skil   Alcohol and/or substance abuse services, skills development
   T1013          No Change       Sign lang/oral interpreter     Sign language or oral interpretive services, per 15 minutes
   T1014          No Change       Telehealth transmit, per min   Telehealth transmission, per minute, professional services bi
   T1015          No Change       Clinic service                 Clinic visit/encounter, all-inclusive
   T1016          No Change       Case management                Case management, each 15 minutes
   T1017          No Change       Targeted case management       Targeted case management, each 15 minutes
   T1018          No Change       School-based iep ser bundled   School-based individualized education program (iep) services,
   T1019          No Change       Personal care ser per 15 min   Personal care services, per 15 minutes, not for an inpatient
   T1020          No Change       Personal care ser per diem     Personal care services, per diem, not for an inpatient or res
   T1021          No Change       Hh aide or cn aide per visit   Home health aide or certified nurse assistant, per visit
   T1022          No Change       Contracted services per day    Contracted home health agency services, all services provided
   T1023          No Change       Program intake assessment      Screening to determine the appropriateness of consideration o
   T1024          No Change       Team evaluation & management   Evaluation and treatment by an integrated, specialty team con
   T1025          No Change       Ped compr care pkg, per diem   Intensive, extended multidisciplinary services provided in a
   T1026          No Change       Ped compr care pkg, per hour   Intensive, extended multidisciplinary services provided in a
   T1027          No Change       Family training & counseling   Family training and counseling for child development, per 15
   T1028          No Change       Home environment assessment    Assessment of home, physical and family environment, to deter
   T1029          No Change       Dwelling lead investigation    Comprehensive environmental lead investigation, not including
   T1030          No Change       Rn home care per diem          Nursing care, in the home, by registered nurse, per diem
   T1031          No Change       Lpn home care per diem         Nursing care, in the home, by licensed practical nurse, per d
   T1040          No Change       Comm bh clinic svc per diem    Medicaid certified community behavioral health clinic service
   T1041          No Change       Comm bh clinic svc per month   Medicaid certified community behavioral health clinic service
   T1502          No Change       Medication admin visit         Administration of oral, intramuscular and/or subcutaneous med
   T1503          No Change       Med admin, not oral/inject     Administration of medication, other than oral and/or injectab
   T1505          No Change       Elec med comp dev, noc         Electronic medication compliance management device, includes
   T1999          No Change       Noc retail items andsupplies   Miscellaneous therapeutic items and supplies, retail purchase
   T2001          No Change       N-et; patient attend/escort    Non-emergency transportation; patient attendant/escort
   T2002          No Change       N-et; per diem                 Non-emergency transportation; per diem
   T2003          No Change       N-et; encounter/trip           Non-emergency transportation; encounter/trip
   T2004          No Change       N-et; commerc carrier pass     Non-emergency transport; commercial carrier, multi-pass
   T2005          No Change       N-et; stretcher van            Non-emergency transportation; stretcher van
   T2007          No Change       Non-emer transport wait time   Transportation waiting time, air ambulance and non-emergency
   T2010          No Change       Pasrr level i                  Preadmission screening and resident review (pasrr) level i id
   T2011          No Change       Pasrr level ii                 Preadmission screening and resident review (pasrr) level ii e
   T2012          No Change       Habil ed waiver, per diem      Habilitation, educational; waiver, per diem
   T2013          No Change       Habil ed waiver per hour       Habilitation, educational, waiver; per hour
   T2014          No Change       Habil prevoc waiver, per d     Habilitation, prevocational, waiver; per diem
   T2015          No Change       Habil prevoc waiver per hr     Habilitation, prevocational, waiver; per hour
   T2016          No Change       Habil res waiver per diem      Habilitation, residential, waiver; per diem
   T2017          No Change       Habil res waiver 15 min        Habilitation, residential, waiver; 15 minutes
   T2018          No Change       Habil sup empl waiver/diem     Habilitation, supported employment, waiver; per diem
   T2019          No Change       Habil sup empl waiver 15min    Habilitation, supported employment, waiver; per 15 minutes
   T2020          No Change       Day habil waiver per diem      Day habilitation, waiver; per diem
   T2021          No Change       Day habil waiver per 15 min    Day habilitation, waiver; per 15 minutes
   T2022          No Change       Case management, per month     Case management, per month
   T2023          No Change       Targeted case mgmt per month   Targeted case management; per month
   T2024          No Change       Serv asmnt/care plan waiver    Service assessment/plan of care development, waiver
   T2025          No Change       Waiver service, nos            Waiver services; not otherwise specified (nos)
   T2026          No Change       Special childcare waiver/d     Specialized childcare, waiver; per diem
   T2027          No Change       Spec childcare waiver 15 min   Specialized childcare, waiver; per 15 minutes
   T2028          No Change       Special supply, nos waiver     Specialized supply, not otherwise specified, waiver
   T2029          No Change       Special med equip, noswaiver   Specialized medical equipment, not otherwise specified, waive
   T2030          No Change       Assist living waiver/month     Assisted living, waiver; per month
   T2031          No Change       Assist living waiver/diem      Assisted living; waiver, per diem
   T2032          No Change       Res care, nos waiver/month     Residential care, not otherwise specified (nos), waiver; per
   T2033          No Change       Res, nos waiver per diem       Residential care, not otherwise specified (nos), waiver; per
   T2034          No Change       Crisis interven waiver/diem    Crisis intervention, waiver; per diem
   T2035          No Change       Utility services waiver        Utility services to support medical equipment and assistive t
   T2036          No Change       Camp overnite waiver/session   Therapeutic camping, overnight, waiver; each session
   T2037          No Change       Camp day waiver/session        Therapeutic camping, day, waiver; each session
   T2038          No Change       Comm trans waiver/service      Community transition, waiver; per service
   T2039          No Change       Vehicle mod waiver/service     Vehicle modifications, waiver; per service
   T2040          No Change       Financial mgt waiver/15min     Financial management, self-directed, waiver; per 15 minutes
   T2041          No Change       Support broker waiver/15 min   Supports brokerage, self-directed, waiver; per 15 minutes
   T2042          No Change       Hospice routine home care      Hospice routine home care; per diem
   T2043          No Change       Hospice continuous home care   Hospice continuous home care; per hour
   T2044          No Change       Hospice respite care           Hospice inpatient respite care; per diem
   T2045          No Change       Hospice general care           Hospice general inpatient care; per diem
   T2046          No Change       Hospice long term care, r&b    Hospice long term care, room and board only; per diem
   T2048          No Change       Bh ltc res r&b, per diem       Behavioral health; long-term care residential (non-acute care
   T2049          No Change       N-et; stretcher van, mileage   Non-emergency transportation; stretcher van, mileage; per mil
   T2101          No Change       Breast milk proc/store/dist    Human breast milk processing, storage and distribution only
   T4521          No Change       Adult size brief/diaper sm     Adult sized disposable incontinence product, brief/diaper, sm
   T4522          No Change       Adult size brief/diaper med    Adult sized disposable incontinence product, brief/diaper, me
   T4523          No Change       Adult size brief/diaper lg     Adult sized disposable incontinence product, brief/diaper, la
   T4524          No Change       Adult size brief/diaper xl     Adult sized disposable incontinence product, brief/diaper, ex
   T4525          No Change       Adult size pull-on sm          Adult sized disposable incontinence product, protective under
   T4526          No Change       Adult size pull-on med         Adult sized disposable incontinence product, protective under
   T4527          No Change       Adult size pull-on lg          Adult sized disposable incontinence product, protective under
   T4528          No Change       Adult size pull-on xl          Adult sized disposable incontinence product, protective under
   T4529          No Change       Ped size brief/diaper sm/med   Pediatric sized disposable incontinence product, brief/diaper
   T4530          No Change       Ped size brief/diaper lg       Pediatric sized disposable incontinence product, brief/diaper
   T4531          No Change       Ped size pull-on sm/med        Pediatric sized disposable incontinence product, protective u
   T4532          No Change       Ped size pull-on lg            Pediatric sized disposable incontinence product, protective u
   T4533          No Change       Youth size brief/diaper        Youth sized disposable incontinence product, brief/diaper, ea
   T4534          No Change       Youth size pull-on             Youth sized disposable incontinence product, protective under
   T4535          No Change       Disposable liner/shield/pad    Disposable liner/shield/guard/pad/undergarment, for incontine
   T4536          No Change       Reusable pull-on any size      Incontinence product, protective underwear/pull-on, reusable,
   T4537          No Change       Reusable underpad bed size     Incontinence product, protective underpad, reusable, bed size
   T4538          No Change       Diaper serv reusable diaper    Diaper service, reusable diaper, each diaper
   T4539          No Change       Reuse diaper/brief any size    Incontinence product, diaper/brief, reusable, any size, each
   T4540          No Change       Reusable underpad chair size   Incontinence product, protective underpad, reusable, chair si
   T4541          No Change       Large disposable underpad      Incontinence product, disposable underpad, large, each
   T4542          No Change       Small disposable underpad      Incontinence product, disposable underpad, small size, each
   T4543          No Change       Adult disp brief/diap abv xl   Adult sized disposable incontinence product, protective brief
   T4544          No Change       Adlt disp und/pull on abv xl   Adult sized disposable incontinence product, protective under
   T5001          No Change       Position seat spec orth need   Positioning seat for persons with special orthopedic needs
   T5999          No Change       Supply, nos                    Supply, not otherwise specified
   V2020          No Change       Vision svcs frames purchases   Frames, purchases
   V2025          No Change       Eyeglasses delux frames        Deluxe frame
   V2100          No Change       Lens spher single plano 4.00   Sphere, single vision, plano to plus or minus 4.00, per lens
   V2101          No Change       Single visn sphere 4.12-7.00   Sphere, single vision, plus or minus 4.12 to plus or minus 7.
   V2102          No Change       Singl visn sphere 7.12-20.00   Sphere, single vision, plus or minus 7.12 to plus or minus 20
   V2103          No Change       Spherocylindr 4.00d/12-2.00d   Spherocylinder, single vision, plano to plus or minus 4.00d s
   V2104          No Change       Spherocylindr 4.00d/2.12-4d    Spherocylinder, single vision, plano to plus or minus 4.00d s
   V2105          No Change       Spherocylinder 4.00d/4.25-6d   Spherocylinder, single vision, plano to plus or minus 4.00d s
   V2106          No Change       Spherocylinder 4.00d/>6.00d    Spherocylinder, single vision, plano to plus or minus 4.00d s
   V2107          No Change       Spherocylinder 4.25d/12-2d     Spherocylinder, single vision, plus or minus 4.25 to plus or
   V2108          No Change       Spherocylinder 4.25d/2.12-4d   Spherocylinder, single vision, plus or minus 4.25d to plus or
   V2109          No Change       Spherocylinder 4.25d/4.25-6d   Spherocylinder, single vision, plus or minus 4.25 to plus or
   V2110          No Change       Spherocylinder 4.25d/over 6d   Spherocylinder, single vision, plus or minus 4.25 to 7.00d sp
   V2111          No Change       Spherocylindr 7.25d/.25-2.25   Spherocylinder, single vision, plus or minus 7.25 to plus or
   V2112          No Change       Spherocylindr 7.25d/2.25-4d    Spherocylinder, single vision, plus or minus 7.25 to plus or
   V2113          No Change       Spherocylindr 7.25d/4.25-6d    Spherocylinder, single vision, plus or minus 7.25 to plus or
   V2114          No Change       Spherocylinder over 12.00d     Spherocylinder, single vision, sphere over plus or minus 12.0
   V2115          No Change       Lens lenticular bifocal        Lenticular, (myodisc), per lens, single vision
   V2118          No Change       Lens aniseikonic single        Aniseikonic lens, single vision
   V2121          No Change       Lenticular lens, single        Lenticular lens, per lens, single
   V2199          No Change       Lens single vision not oth c   Not otherwise classified, single vision lens
   V2200          No Change       Lens spher bifoc plano 4.00d   Sphere, bifocal, plano to plus or minus 4.00d, per lens
   V2201          No Change       Lens sphere bifocal 4.12-7.0   Sphere, bifocal, plus or minus 4.12 to plus or minus 7.00d, p
   V2202          No Change       Lens sphere bifocal 7.12-20.   Sphere, bifocal, plus or minus 7.12 to plus or minus 20.00d,
   V2203          No Change       Lens sphcyl bifocal 4.00d/.1   Spherocylinder, bifocal, plano to plus or minus 4.00d sphere,
   V2204          No Change       Lens sphcy bifocal 4.00d/2.1   Spherocylinder, bifocal, plano to plus or minus 4.00d sphere,
   V2205          No Change       Lens sphcy bifocal 4.00d/4.2   Spherocylinder, bifocal, plano to plus or minus 4.00d sphere,
   V2206          No Change       Lens sphcy bifocal 4.00d/ove   Spherocylinder, bifocal, plano to plus or minus 4.00d sphere,
   V2207          No Change       Lens sphcy bifocal 4.25-7d/.   Spherocylinder, bifocal, plus or minus 4.25 to plus or minus
   V2208          No Change       Lens sphcy bifocal 4.25-7/2.   Spherocylinder, bifocal, plus or minus 4.25 to plus or minus
   V2209          No Change       Lens sphcy bifocal 4.25-7/4.   Spherocylinder, bifocal, plus or minus 4.25 to plus or minus
   V2210          No Change       Lens sphcy bifocal 4.25-7/ov   Spherocylinder, bifocal, plus or minus 4.25 to plus or minus
   V2211          No Change       Lens sphcy bifo 7.25-12/.25-   Spherocylinder, bifocal, plus or minus 7.25 to plus or minus
   V2212          No Change       Lens sphcyl bifo 7.25-12/2.2   Spherocylinder, bifocal, plus or minus 7.25 to plus or minus
   V2213          No Change       Lens sphcyl bifo 7.25-12/4.2   Spherocylinder, bifocal, plus or minus 7.25 to plus or minus
   V2214          No Change       Lens sphcyl bifocal over 12.   Spherocylinder, bifocal, sphere over plus or minus 12.00d, pe
   V2215          No Change       Lens lenticular bifocal        Lenticular (myodisc), per lens, bifocal
   V2218          No Change       Lens aniseikonic bifocal       Aniseikonic, per lens, bifocal
   V2219          No Change       Lens bifocal seg width over    Bifocal seg width over 28 mm
   V2220          No Change       Lens bifocal add over 3.25d    Bifocal add over 3.25d
   V2221          No Change       Lenticular lens, bifocal       Lenticular lens, per lens, bifocal
   V2299          No Change       Lens bifocal speciality        Specialty bifocal (by report)
   V2300          No Change       Lens sphere trifocal 4.00d     Sphere, trifocal, plano to plus or minus 4.00d, per lens
   V2301          No Change       Lens sphere trifocal 4.12-7.   Sphere, trifocal, plus or minus 4.12 to plus or minus 7.00d,
   V2302          No Change       Lens sphere trifocal 7.12-20   Sphere, trifocal, plus or minus 7.12 to plus or minus 20.00,
   V2303          No Change       Lens sphcy trifocal 4.0/.12-   Spherocylinder, trifocal, plano to plus or minus 4.00d sphere
   V2304          No Change       Lens sphcy trifocal 4.0/2.25   Spherocylinder, trifocal, plano to plus or minus 4.00d sphere
   V2305          No Change       Lens sphcy trifocal 4.0/4.25   Spherocylinder, trifocal, plano to plus or minus 4.00d sphere
   V2306          No Change       Lens sphcyl trifocal 4.00/>6   Spherocylinder, trifocal, plano to plus or minus 4.00d sphere
   V2307          No Change       Lens sphcy trifocal 4.25-7/.   Spherocylinder, trifocal, plus or minus 4.25 to plus or minus
   V2308          No Change       Lens sphc trifocal 4.25-7/2.   Spherocylinder, trifocal, plus or minus 4.25 to plus or minus
   V2309          No Change       Lens sphc trifocal 4.25-7/4.   Spherocylinder, trifocal, plus or minus 4.25 to plus or minus
   V2310          No Change       Lens sphc trifocal 4.25-7/>6   Spherocylinder, trifocal, plus or minus 4.25 to plus or minus
   V2311          No Change       Lens sphc trifo 7.25-12/.25-   Spherocylinder, trifocal, plus or minus 7.25 to plus or minus
   V2312          No Change       Lens sphc trifo 7.25-12/2.25   Spherocylinder, trifocal, plus or minus 7.25 to plus or minus
   V2313          No Change       Lens sphc trifo 7.25-12/4.25   Spherocylinder, trifocal, plus or minus 7.25 to plus or minus
   V2314          No Change       Lens sphcyl trifocal over 12   Spherocylinder, trifocal, sphere over plus or minus 12.00d, p
   V2315          No Change       Lens lenticular trifocal       Lenticular, (myodisc), per lens, trifocal
   V2318          No Change       Lens aniseikonic trifocal      Aniseikonic lens, trifocal
   V2319          No Change       Lens trifocal seg width > 28   Trifocal seg width over 28 mm
   V2320          No Change       Lens trifocal add over 3.25d   Trifocal add over 3.25d
   V2321          No Change       Lenticular lens, trifocal      Lenticular lens, per lens, trifocal
   V2399          No Change       Lens trifocal speciality       Specialty trifocal (by report)
   V2410          No Change       Lens variab asphericity sing   Variable asphericity lens, single vision, full field, glass o
   V2430          No Change       Lens variable asphericity bi   Variable asphericity lens, bifocal, full field, glass or plas
   V2499          No Change       Variable asphericity lens      Variable sphericity lens, other type
   V2500          No Change       Contact lens pmma spherical    Contact lens, pmma, spherical, per lens
   V2501          No Change       Cntct lens pmma-toric/prism    Contact lens, pmma, toric or prism ballast, per lens
   V2502          No Change       Contact lens pmma bifocal      Contact lens, pmma, bifocal, per lens
   V2503          No Change       Cntct lens pmma color vision   Contact lens, pmma, color vision deficiency, per lens
   V2510          No Change       Cntct gas permeable sphericl   Contact lens, gas permeable, spherical, per lens
   V2511          No Change       Cntct toric prism ballast      Contact lens, gas permeable, toric, prism ballast, per lens
   V2512          No Change       Cntct lens gas permbl bifocl   Contact lens, gas permeable, bifocal, per lens
   V2513          No Change       Contact lens extended wear     Contact lens, gas permeable, extended wear, per lens
   V2520          No Change       Contact lens hydrophilic       Contact lens, hydrophilic, spherical, per lens
   V2521          No Change       Cntct lens hydrophilic toric   Contact lens, hydrophilic, toric, or prism ballast, per lens
   V2522          No Change       Cntct lens hydrophil bifocl    Contact lens, hydrophilic, bifocal, per lens
   V2523          No Change       Cntct lens hydrophil extend    Contact lens, hydrophilic, extended wear, per lens
   V2530          No Change       Contact lens gas impermeable   Contact lens, scleral, gas impermeable, per lens (for contact
   V2531          No Change       Contact lens gas permeable     Contact lens, scleral, gas permeable, per lens (for contact l
   V2599          No Change       Contact lens/es other type     Contact lens, other type
   V2600          No Change       Hand held low vision aids      Hand held low vision aids and other nonspectacle mounted aids
   V2610          No Change       Single lens spectacle mount    Single lens spectacle mounted low vision aids
   V2615          No Change       Telescop/othr compound lens    Telescopic and other compound lens system, including distance
   V2623          No Change       Plastic eye prosth custom      Prosthetic eye, plastic, custom
   V2624          No Change       Polishing artifical eye        Polishing/resurfacing of ocular prosthesis
   V2625          No Change       Enlargemnt of eye prosthesis   Enlargement of ocular prosthesis
   V2626          No Change       Reduction of eye prosthesis    Reduction of ocular prosthesis
   V2627          No Change       Scleral cover shell            Scleral cover shell
   V2628          No Change       Fabrication & fitting          Fabrication and fitting of ocular conformer
   V2629          No Change       Prosthetic eye other type      Prosthetic eye, other type
   V2630          No Change       Anter chamber intraocul lens   Anterior chamber intraocular lens
   V2631          No Change       Iris support intraoclr lens    Iris supported intraocular lens
   V2632          No Change       Post chmbr intraocular lens    Posterior chamber intraocular lens
   V2700          No Change       Balance lens                   Balance lens, per lens
   V2702          No Change       Deluxe lens feature            Deluxe lens feature
   V2710          No Change       Glass/plastic slab off prism   Slab off prism, glass or plastic, per lens
   V2715          No Change       Prism lens/es                  Prism, per lens
   V2718          No Change       Fresnell prism press-on lens   Press-on lens, fresnell prism, per lens
   V2730          No Change       Special base curve             Special base curve, glass or plastic, per lens
   V2744          No Change       Tint photochromatic lens/es    Tint, photochromatic, per lens
   V2745          No Change       Tint, any color/solid/grad     Addition to lens; tint, any color, solid, gradient or equal,
   V2750          No Change       Anti-reflective coating        Anti-reflective coating, per lens
   V2755          No Change       Uv lens/es                     U-v lens, per lens
   V2756          No Change       Eye glass case                 Eye glass case
   V2760          No Change       Scratch resistant coating      Scratch resistant coating, per lens
   V2761          No Change       Mirror coating                 Mirror coating, any type, solid, gradient or equal, any lens
   V2762          No Change       Polarization, any lens         Polarization, any lens material, per lens
   V2770          No Change       Occluder lens/es               Occluder lens, per lens
   V2780          No Change       Oversize lens/es               Oversize lens, per lens
   V2781          No Change       Progressive lens per lens      Progressive lens, per lens
   V2782          No Change       Lens, 1.54-1.65 p/1.60-1.79g   Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, exclu
   V2783          No Change       Lens, >= 1.66 p/>=1.80 g       Lens, index greater than or equal to 1.66 plastic or greater
   V2784          No Change       Lens polycarb or equal         Lens, polycarbonate or equal, any index, per lens
   V2785          No Change       Corneal tissue processing      Processing, preserving and transporting corneal tissue
   V2786          No Change       Occupational multifocal lens   Specialty occupational multifocal lens, per lens
   V2787          No Change       Astigmatism-correct function   Astigmatism correcting function of intraocular lens
   V2788          No Change       Presbyopia-correct function    Presbyopia correcting function of intraocular lens
   V2790          No Change       Amniotic membrane              Amniotic membrane for surgical reconstruction, per procedure
   V2797          No Change       Vis item/svc in other code     Vision supply, accessory and/or service component of another
   V2799          No Change       Misc vision item or service    Vision item or service, miscellaneous
   V5008          No Change       Hearing screening              Hearing screening
   V5010          No Change       Assessment for hearing aid     Assessment for hearing aid
   V5011          No Change       Hearing aid fitting/checking   Fitting/orientation/checking of hearing aid
   V5014          No Change       Hearing aid repair/modifying   Repair/modification of a hearing aid
   V5020          No Change       Conformity evaluation          Conformity evaluation
   V5030          No Change       Body-worn hearing aid air      Hearing aid, monaural, body worn, air conduction
   V5040          No Change       Body-worn hearing aid bone     Hearing aid, monaural, body worn, bone conduction
   V5050          No Change       Hearing aid monaural in ear    Hearing aid, monaural, in the ear
   V5060          No Change       Behind ear hearing aid         Hearing aid, monaural, behind the ear
   V5070          No Change       Glasses air conduction         Glasses, air conduction
   V5080          No Change       Glasses bone conduction        Glasses, bone conduction
   V5090          No Change       Hearing aid dispensing fee     Dispensing fee, unspecified hearing aid
   V5095          No Change       Implant mid ear hearing pros   Semi-implantable middle ear hearing prosthesis
   V5100          No Change       Body-worn bilat hearing aid    Hearing aid, bilateral, body worn
   V5110          No Change       Hearing aid dispensing fee     Dispensing fee, bilateral
   V5120          No Change       Body-worn binaur hearing aid   Binaural, body
   V5130          No Change       In ear binaural hearing aid    Binaural, in the ear
   V5140          No Change       Behind ear binaur hearing ai   Binaural, behind the ear
   V5150          No Change       Glasses binaural hearing aid   Binaural, glasses
   V5160          No Change       Dispensing fee binaural        Dispensing fee, binaural
   V5241          No Change       Dispensing fee, monaural       Dispensing fee, monaural hearing aid, any type
   V5242          No Change       Hearing aid, monaural, cic     Hearing aid, analog, monaural, cic (completely in the ear can
   V5243          No Change       Hearing aid, monaural, itc     Hearing aid, analog, monaural, itc (in the canal)
   V5244          No Change       Hearing aid, prog, mon, cic    Hearing aid, digitally programmable analog, monaural, cic
   V5245          No Change       Hearing aid, prog, mon, itc    Hearing aid, digitally programmable, analog, monaural, itc
   V5246          No Change       Hearing aid, prog, mon, ite    Hearing aid, digitally programmable analog, monaural, ite (in
   V5247          No Change       Hearing aid, prog, mon, bte    Hearing aid, digitally programmable analog, monaural, bte (be
   V5248          No Change       Hearing aid, binaural, cic     Hearing aid, analog, binaural, cic
   V5249          No Change       Hearing aid, binaural, itc     Hearing aid, analog, binaural, itc
   V5250          No Change       Hearing aid, prog, bin, cic    Hearing aid, digitally programmable analog, binaural, cic
   V5251          No Change       Hearing aid, prog, bin, itc    Hearing aid, digitally programmable analog, binaural, itc
   V5252          No Change       Hearing aid, prog, bin, ite    Hearing aid, digitally programmable, binaural, ite
   V5253          No Change       Hearing aid, prog, bin, bte    Hearing aid, digitally programmable, binaural, bte
   V5254          No Change       Hearing id, digit, mon, cic    Hearing aid, digital, monaural, cic
   V5255          No Change       Hearing aid, digit, mon, itc   Hearing aid, digital, monaural, itc
   V5256          No Change       Hearing aid, digit, mon, ite   Hearing aid, digital, monaural, ite
   V5257          No Change       Hearing aid, digit, mon, bte   Hearing aid, digital, monaural, bte
   V5258          No Change       Hearing aid, digit, bin, cic   Hearing aid, digital, binaural, cic
   V5259          No Change       Hearing aid, digit, bin, itc   Hearing aid, digital, binaural, itc
   V5260          No Change       Hearing aid, digit, bin, ite   Hearing aid, digital, binaural, ite
   V5261          No Change       Hearing aid, digit, bin, bte   Hearing aid, digital, binaural, bte
   V5262          No Change       Hearing aid, disp, monaural    Hearing aid, disposable, any type, monaural
   V5263          No Change       Hearing aid, disp, binaural    Hearing aid, disposable, any type, binaural
   V5264          No Change       Ear mold/insert                Ear mold/insert, not disposable, any type
   V5265          No Change       Ear mold/insert, disp          Ear mold/insert, disposable, any type
   V5266          No Change       Battery for hearing device     Battery for use in hearing device
   V5267          No Change       Hearing aid sup/access/dev     Hearing aid or assistive listening device/supplies/accessorie
   V5268          No Change       Ald telephone amplifier        Assistive listening device, telephone amplifier, any type
   V5269          No Change       Alerting device, any type      Assistive listening device, alerting, any type
   V5270          No Change       Ald, tv amplifier, any type    Assistive listening device, television amplifier, any type
   V5271          No Change       Ald, tv caption decoder        Assistive listening device, television caption decoder
   V5272          No Change       Tdd                            Assistive listening device, tdd
   V5273          No Change       Ald for cochlear implant       Assistive listening device, for use with cochlear implant
   V5274          No Change       Ald unspecified                Assistive listening device, not otherwise specified
   V5275          No Change       Ear impression                 Ear impression, each
   V5281          No Change       Ald fm/dm system, monaural     Assistive listening device, personal fm/dm system, monaural,
   V5282          No Change       Ald fm/dm system binaural      Assistive listening device, personal fm/dm system, binaural,
   V5283          No Change       Ald neck, loop ind receiver    Assistive listening device, personal fm/dm neck, loop inducti
   V5284          No Change       Ald fm/dm ear level receiver   Assistive listening device, personal fm/dm, ear level receive
   V5285          No Change       Ald fm/dm aud input receiver   Assistive listening device, personal fm/dm, direct audio inpu
   V5286          No Change       Ald blu tooth fm/dm receiver   Assistive listening device, personal blue tooth fm/dm receive
   V5287          No Change       Ald fm/dm receiver, nos        Assistive listening device, personal fm/dm receiver, not othe
   V5288          No Change       Ald fm/dm transmitter ald      Assistive listening device, personal fm/dm transmitter assist
   V5289          No Change       Ald fm/dm adapt/boot couplin   Assistive listening device, personal fm/dm adapter/boot coupl
   V5290          No Change       Ald transmitter microphone     Assistive listening device, transmitter microphone, any type
   V5298          No Change       Hearing aid noc                Hearing aid, not otherwise classified
   V5299          No Change       Hearing service                Hearing service, miscellaneous
   V5336          No Change       Repair communication device    Repair/modification of augmentative communicative system or d
   V5362          No Change       Speech screening               Speech screening
   V5363          No Change       Language screening             Language screening
   V5364          No Change       Dysphagia screening            Dysphagia screening
   A9515        Payment Change    Choline c-11                   Choline c-11, diagnostic, per study dose up to 20 millicuries
   A9586        Payment Change    Florbetapir f18                Florbetapir f18, diagnostic, per study dose, up to 10 millicu
   C2644        Payment Change    Brachytx cesium-131 chloride   Brachytherapy source, cesium-131 chloride solution, per milli
   C9248        Payment Change    Inj, clevidipine butyrate      Injection, clevidipine butyrate, 1 mg
   C9290        Payment Change    Inj, bupivacaine liposome      Injection, bupivacaine liposome, 1 mg
   C9447        Payment Change    Inj, phenylephrine ketorolac   Injection, phenylephrine and ketorolac, 4 ml vial
   E2351        Payment Change    Electronic sgd interface       Power wheelchair accessory, electronic interface to operate s
   E2500        Payment Change    Sgd digitized pre-rec <=8min   Speech generating device, digitized speech, using pre-recorde
   E2502        Payment Change    Sgd prerec msg >8min <=20min   Speech generating device, digitized speech, using pre-recorde
   E2504        Payment Change    Sgd prerec msg>20min <=40min   Speech generating device, digitized speech, using pre-recorde
   E2506        Payment Change    Sgd prerec msg > 40 min        Speech generating device, digitized speech, using pre-recorde
   E2508        Payment Change    Sgd spelling phys contact      Speech generating device, synthesized speech, requiring messa
   E2510        Payment Change    Sgd w multi methods msg/accs   Speech generating device, synthesized speech, permitting mult
   J0400        Payment Change    Aripiprazole injection         Injection, aripiprazole, intramuscular, 0.25 mg
   J0470        Payment Change    Dimecaprol injection           Injection, dimercaprol, per 100 mg
   J0476        Payment Change    Baclofen intrathecal trial     Injection, baclofen, 50 mcg for intrathecal trial
   J0558        Payment Change    Peng benzathine/procaine inj   Injection, penicillin g benzathine and penicillin g procaine,
   J0725        Payment Change    Chorionic gonadotropin/1000u   Injection, chorionic gonadotropin, per 1,000 usp units
   J0800        Payment Change    Corticotropin injection        Injection, corticotropin, up to 40 units
   J0888        Payment Change    Epoetin beta non esrd          Injection, epoetin beta, 1 microgram, (for non esrd use)
   J1110        Payment Change    Inj dihydroergotamine mesylt   Injection, dihydroergotamine mesylate, per 1 mg
   J1130        Payment Change    Inj diclofenac sodium 0.5mg    Injection, diclofenac sodium, 0.5 mg
   J2503        Payment Change    Pegaptanib sodium injection    Injection, pegaptanib sodium, 0.3 mg
   J2793        Payment Change    Rilonacept injection           Injection, rilonacept, 1 mg
   J2941        Payment Change    Somatropin injection           Injection, somatropin, 1 mg
   J3070        Payment Change    Pentazocine injection          Injection, pentazocine, 30 mg
   J3465        Payment Change    Injection, voriconazole        Injection, voriconazole, 10 mg
   J7340        Payment Change    Carbidopa levodopa ent 100ml   Carbidopa 5 mg/levodopa 20 mg enteral suspension, 100 ml
   J7503        Payment Change    Tacrol envarsus ex rel oral    Tacrolimus, extended release, (envarsus xr), oral, 0.25 mg
   J7505        Payment Change    Monoclonal antibodies          Muromonab-cd3, parenteral, 5 mg
   J8501        Payment Change    Oral aprepitant                Aprepitant, oral, 5 mg
   J8562        Payment Change    Oral fludarabine phosphate     Fludarabine phosphate, oral, 10 mg
   J8600        Payment Change    Melphalan oral 2 mg            Melphalan; oral, 2 mg
   J8705        Payment Change    Topotecan oral                 Topotecan, oral, 0.25 mg
   J9151        Payment Change    Daunorubicin citrate inj       Injection, daunorubicin citrate, liposomal formulation, 10 mg
   J9185        Payment Change    Fludarabine phosphate inj      Injection, fludarabine phosphate, 50 mg
   J9211        Payment Change    Idarubicin hcl injection       Injection, idarubicin hydrochloride, 5 mg
   J9213        Payment Change    Interferon alfa-2a inj         Injection, interferon, alfa-2a, recombinant, 3 million units
   J9216        Payment Change    Interferon gamma 1-b inj       Injection, interferon, gamma 1-b, 3 million units
   J9218        Payment Change    Leuprolide acetate injeciton   Leuprolide acetate, per 1 mg
   J9270        Payment Change    Plicamycin (mithramycin) inj   Injection, plicamycin, 2.5 mg
   Q2009        Payment Change    Fosphenytoin inj pe            Injection, fosphenytoin, 50 mg phenytoin equivalent
   Q2026        Payment Change    Radiesse injection             Injection, radiesse, 0.1 ml
   Q2028        Payment Change    Inj, sculptra, 0.5mg           Injection, sculptra, 0.5 mg
   Q9950        Payment Change    Inj sulf hexa lipid microsph   Injection, sulfur hexafluoride lipid microspheres, per ml
   Q9982        Payment Change    Flutemetamol f18 diagnostic    Flutemetamol f18, diagnostic, per study dose, up to 5 millicu
   Q9983        Payment Change    Florbetaben f18 diagnostic     Florbetaben f18, diagnostic, per study dose, up to 8.1 millic
   G0516    Short Description ChanInsert drug del implant, >=4   Insertion of non-biodegradable drug delivery implants, 4 or m
   G8807    Short Description ChanNo ta tv ultrasnd              Trans-abdominal or trans-vaginal ultrasound not performed for
   G9690    Short Description ChanPt in hos                      Patient receiving hospice services any time during the measur
   G9787    Short Description ChanPt alive                       Patient alive as of the last day of the measurement year
   G9974    Short Description ChanMac exam perf                  Dilated macular exam performed, including documentation of th
   G9975    Short Description ChanDoc med rsn no dil mac exam    Documentation of medical reason(s) for not performing a dilat
   J0295    Short Description ChanAmpicillin sulbactam 1.5 gm    Injection, ampicillin sodium/sulbactam sodium, per 1.5 gm
   P9073    Short Description ChanPlatelets pheresis path redu   Platelets, pheresis, pathogen-reduced, each unit
