{
"description": null,
"sourceCanonical": "http://www.cms.gov/Medicare/Coding/MedHCPCSGenInfo/index.html",
"_filename": "conceptmap-hcpcs2cpt.json",
"package_name": "tiga.health.clinical",
"date": null,
"group": [ {
"source": "http://www.cms.gov/Medicare/Coding/MedHCPCSGenInfo/index.html",
"target": "https://www.ama-assn.org/cpt",
"element": [ {
"code": "MTHU000319",
"target": [ {
"code": "1021910",
"comment": "exact match",
"display": "Level II (HCPCS/National) Modifiers",
"equivalence": "equivalent"
} ],
"display": "HCPCS Level II National Modifiers"
}, {
"code": "A1",
"target": [ {
"code": "A1",
"comment": "exact match",
"display": "Dressing for one wound",
"equivalence": "equivalent"
} ],
"display": "Dressing for one wound"
}, {
"code": "A2",
"target": [ {
"code": "A2",
"comment": "exact match",
"display": "Dressing for two wounds",
"equivalence": "equivalent"
} ],
"display": "Dressing for two wounds"
}, {
"code": "A3",
"target": [ {
"code": "A3",
"comment": "exact match",
"display": "Dressing for three wounds",
"equivalence": "equivalent"
} ],
"display": "Dressing for three wounds"
}, {
"code": "A4",
"target": [ {
"code": "A4",
"comment": "exact match",
"display": "Dressing for four wounds",
"equivalence": "equivalent"
} ],
"display": "Dressing for four wounds"
}, {
"code": "A5",
"target": [ {
"code": "A5",
"comment": "exact match",
"display": "Dressing for five wounds",
"equivalence": "equivalent"
} ],
"display": "Dressing for five wounds"
}, {
"code": "A6",
"target": [ {
"code": "A6",
"comment": "exact match",
"display": "Dressing for six wounds",
"equivalence": "equivalent"
} ],
"display": "Dressing for six wounds"
}, {
"code": "A7",
"target": [ {
"code": "A7",
"comment": "exact match",
"display": "Dressing for seven wounds",
"equivalence": "equivalent"
} ],
"display": "Dressing for seven wounds"
}, {
"code": "A8",
"target": [ {
"code": "A8",
"comment": "exact match",
"display": "Dressing for eight wounds",
"equivalence": "equivalent"
} ],
"display": "Dressing for eight wounds"
}, {
"code": "A9",
"target": [ {
"code": "A9",
"comment": "exact match",
"display": "Dressing for nine or more wounds",
"equivalence": "equivalent"
} ],
"display": "Dressing for nine or more wounds"
}, {
"code": "AA",
"target": [ {
"code": "AA",
"comment": "exact match",
"display": "Anesthesia services performed personally by anesthesiologist",
"equivalence": "equivalent"
} ],
"display": "Anesthesia services performed personally by anesthesiologist"
}, {
"code": "AD",
"target": [ {
"code": "AD",
"comment": "exact match",
"display": "Medical supervision by a physician: more than four concurrent anesthesia procedures",
"equivalence": "equivalent"
} ],
"display": "Medical supervision by a physician: more than four concurrent anesthesia procedures"
}, {
"code": "AE",
"target": [ {
"code": "AE",
"comment": "exact match",
"display": "Registered dietician",
"equivalence": "equivalent"
} ],
"display": "Registered dietician"
}, {
"code": "AF",
"target": [ {
"code": "AF",
"comment": "exact match",
"display": "Specialty physician",
"equivalence": "equivalent"
} ],
"display": "Specialty physician"
}, {
"code": "AG",
"target": [ {
"code": "AG",
"comment": "exact match",
"display": "Primary physician",
"equivalence": "equivalent"
} ],
"display": "Primary physician"
}, {
"code": "AH",
"target": [ {
"code": "AH",
"comment": "exact match",
"display": "Clinical psychologist",
"equivalence": "equivalent"
} ],
"display": "Clinical psychologist"
}, {
"code": "AI",
"target": [ {
"code": "AI",
"comment": "exact match",
"display": "Principal physician of record",
"equivalence": "equivalent"
} ],
"display": "Principal physician of record"
}, {
"code": "AJ",
"target": [ {
"code": "AJ",
"comment": "exact match",
"display": "Clinical social worker",
"equivalence": "equivalent"
} ],
"display": "Clinical social worker"
}, {
"code": "AK",
"target": [ {
"code": "AK",
"comment": "exact match",
"display": "Non participating physician",
"equivalence": "equivalent"
} ],
"display": "Non participating physician"
}, {
"code": "AM",
"target": [ {
"code": "AM",
"comment": "exact match",
"display": "Physician, team member service",
"equivalence": "equivalent"
} ],
"display": "Physician, team member service"
}, {
"code": "AO",
"target": [ {
"code": "AO",
"comment": "exact match",
"display": "Alternate payment method declined by provider of service",
"equivalence": "equivalent"
} ],
"display": "Alternate payment method declined by provider of service"
}, {
"code": "AP",
"target": [ {
"code": "AP",
"comment": "exact match",
"display": "Determination of refractive state was not performed in the course of diagnostic ophthalmological examination",
"equivalence": "equivalent"
} ],
"display": "Determination of refractive state was not performed in the course of diagnostic ophthalmological examination"
}, {
"code": "AQ",
"target": [ {
"code": "AQ",
"comment": "exact match",
"display": "Physician providing a service in an unlisted health professional shortage area (hpsa)",
"equivalence": "equivalent"
} ],
"display": "Physician providing a service in an unlisted health professional shortage area (hpsa)"
}, {
"code": "AR",
"target": [ {
"code": "AR",
"comment": "exact match",
"display": "Physician provider services in a physician scarcity area",
"equivalence": "equivalent"
} ],
"display": "Physician provider services in a physician scarcity area"
}, {
"code": "AS",
"target": [ {
"code": "AS",
"comment": "exact match",
"display": "Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery",
"equivalence": "equivalent"
} ],
"display": "Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery"
}, {
"code": "AT",
"target": [ {
"code": "AT",
"comment": "exact match",
"display": "Acute treatment (this modifier should be used when reporting service 98940, 98941, 98942)",
"equivalence": "equivalent"
} ],
"display": "Acute treatment (this modifier should be used when reporting service 98940, 98941, 98942)"
}, {
"code": "AU",
"target": [ {
"code": "AU",
"comment": "exact match",
"display": "Item furnished in conjunction with a urological, ostomy, or tracheostomy supply",
"equivalence": "equivalent"
} ],
"display": "Item furnished in conjunction with a urological, ostomy, or tracheostomy supply"
}, {
"code": "AV",
"target": [ {
"code": "AV",
"comment": "exact match",
"display": "Item furnished in conjunction with a prosthetic device, prosthetic or orthotic",
"equivalence": "equivalent"
} ],
"display": "Item furnished in conjunction with a prosthetic device, prosthetic or orthotic"
}, {
"code": "AW",
"target": [ {
"code": "AW",
"comment": "exact match",
"display": "Item furnished in conjunction with a surgical dressing",
"equivalence": "equivalent"
} ],
"display": "Item furnished in conjunction with a surgical dressing"
}, {
"code": "AX",
"target": [ {
"code": "AX",
"comment": "exact match",
"display": "Item furnished in conjunction with dialysis services",
"equivalence": "equivalent"
} ],
"display": "Item furnished in conjunction with dialysis services"
}, {
"code": "AY",
"target": [ {
"code": "AY",
"comment": "exact match",
"display": "Item or service furnished to an esrd patient that is not for the treatment of esrd",
"equivalence": "equivalent"
} ],
"display": "Item or service furnished to an esrd patient that is not for the treatment of esrd"
}, {
"code": "AZ",
"target": [ {
"code": "AZ",
"comment": "exact match",
"display": "Physician providing a service in a dental health professional shortage area for the purpose of an electronic health record incentive payment",
"equivalence": "equivalent"
} ],
"display": "Physician providing a service in a dental health professional shortage area for the purpose of an electronic health record incentive payment"
}, {
"code": "BA",
"target": [ {
"code": "BA",
"comment": "exact match",
"display": "Item furnished in conjunction with parenteral enteral nutrition (pen) services",
"equivalence": "equivalent"
} ],
"display": "Item furnished in conjunction with parenteral enteral nutrition (pen) services"
}, {
"code": "BL",
"target": [ {
"code": "BL",
"comment": "exact match",
"display": "Special acquisition of blood and blood products",
"equivalence": "equivalent"
} ],
"display": "Special acquisition of blood and blood products"
}, {
"code": "BO",
"target": [ {
"code": "BO",
"comment": "exact match",
"display": "Orally administered nutrition, not by feeding tube",
"equivalence": "equivalent"
} ],
"display": "Orally administered nutrition, not by feeding tube"
}, {
"code": "BP",
"target": [ {
"code": "BP",
"comment": "exact match",
"display": "The beneficiary has been informed of the purchase and rental options and has elected to purchase the item",
"equivalence": "equivalent"
} ],
"display": "The beneficiary has been informed of the purchase and rental options and has elected to purchase the item"
}, {
"code": "BR",
"target": [ {
"code": "BR",
"comment": "exact match",
"display": "The beneficiary has been informed of the purchase and rental options and has elected to rent the item",
"equivalence": "equivalent"
} ],
"display": "The beneficiary has been informed of the purchase and rental options and has elected to rent the item"
}, {
"code": "BU",
"target": [ {
"code": "BU",
"comment": "exact match",
"display": "The beneficiary has been informed of the purchase and rental options and after 30 days has not informed the supplier of his/her decision",
"equivalence": "equivalent"
} ],
"display": "The beneficiary has been informed of the purchase and rental options and after 30 days has not informed the supplier of his/her decision"
}, {
"code": "CA",
"target": [ {
"code": "CA",
"comment": "exact match",
"display": "Procedure payable only in the inpatient setting when performed emergently on an outpatient who expires prior to admission",
"equivalence": "equivalent"
} ],
"display": "Procedure payable only in the inpatient setting when performed emergently on an outpatient who expires prior to admission"
}, {
"code": "CB",
"target": [ {
"code": "CB",
"comment": "exact match",
"display": "Service ordered by a renal dialysis facility (rdf) physician as part of the esrd beneficiary's dialysis benefit, is not part of the composite rate, and is separately reimbursable",
"equivalence": "equivalent"
} ],
"display": "Service ordered by a renal dialysis facility (rdf) physician as part of the esrd beneficiary's dialysis benefit, is not part of the composite rate, and is separately reimbursable"
}, {
"code": "CC",
"target": [ {
"code": "CC",
"comment": "exact match",
"display": "Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed)",
"equivalence": "equivalent"
} ],
"display": "Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed)"
}, {
"code": "CD",
"target": [ {
"code": "CD",
"comment": "exact match",
"display": "Amcc test has been ordered by an esrd facility or mcp physician that is part of the composite rate and is not separately billable",
"equivalence": "equivalent"
} ],
"display": "Amcc test has been ordered by an esrd facility or mcp physician that is part of the composite rate and is not separately billable"
}, {
"code": "CE",
"target": [ {
"code": "CE",
"comment": "exact match",
"display": "Amcc test has been ordered by an esrd facility or mcp physician that is a composite rate test but is beyond the normal frequency covered under the rate and is separately reimbursable based on medical necessity",
"equivalence": "equivalent"
} ],
"display": "Amcc test has been ordered by an esrd facility or mcp physician that is a composite rate test but is beyond the normal frequency covered under the rate and is separately reimbursable based on medical necessity"
}, {
"code": "CF",
"target": [ {
"code": "CF",
"comment": "exact match",
"display": "Amcc test has been ordered by an esrd facility or mcp physician that is not part of the composite rate and is separately billable",
"equivalence": "equivalent"
} ],
"display": "Amcc test has been ordered by an esrd facility or mcp physician that is not part of the composite rate and is separately billable"
}, {
"code": "CG",
"target": [ {
"code": "CG",
"comment": "exact match",
"display": "Policy criteria applied",
"equivalence": "equivalent"
} ],
"display": "Policy criteria applied"
}, {
"code": "CH",
"target": [ {
"code": "CH",
"comment": "exact match",
"display": "0 percent impaired, limited or restricted",
"equivalence": "equivalent"
} ],
"display": "0 percent impaired, limited or restricted"
}, {
"code": "CI",
"target": [ {
"code": "CI",
"comment": "exact match",
"display": "At least 1 percent but less than 20 percent impaired, limited or restricted",
"equivalence": "equivalent"
} ],
"display": "At least 1 percent but less than 20 percent impaired, limited or restricted"
}, {
"code": "CJ",
"target": [ {
"code": "CJ",
"comment": "exact match",
"display": "At least 20 percent but less than 40 percent impaired, limited or restricted",
"equivalence": "equivalent"
} ],
"display": "At least 20 percent but less than 40 percent impaired, limited or restricted"
}, {
"code": "CK",
"target": [ {
"code": "CK",
"comment": "exact match",
"display": "At least 40 percent but less than 60 percent impaired, limited or restricted",
"equivalence": "equivalent"
} ],
"display": "At least 40 percent but less than 60 percent impaired, limited or restricted"
}, {
"code": "CL",
"target": [ {
"code": "CL",
"comment": "exact match",
"display": "At least 60 percent but less than 80 percent impaired, limited or restricted",
"equivalence": "equivalent"
} ],
"display": "At least 60 percent but less than 80 percent impaired, limited or restricted"
}, {
"code": "CM",
"target": [ {
"code": "CM",
"comment": "exact match",
"display": "At least 80 percent but less than 100 percent impaired, limited or restricted",
"equivalence": "equivalent"
} ],
"display": "At least 80 percent but less than 100 percent impaired, limited or restricted"
}, {
"code": "CN",
"target": [ {
"code": "CN",
"comment": "exact match",
"display": "100 percent impaired, limited or restricted",
"equivalence": "equivalent"
} ],
"display": "100 percent impaired, limited or restricted"
}, {
"code": "CO",
"target": [ {
"code": "CO",
"comment": "exact match",
"display": "Outpatient occupational therapy services furnished in whole or in part by an occupational therapy assistant",
"equivalence": "equivalent"
} ],
"display": "Outpatient occupational therapy services furnished in whole or in part by an occupational therapy assistant"
}, {
"code": "CQ",
"target": [ {
"code": "CQ",
"comment": "exact match",
"display": "Outpatient physical therapy services furnished in whole or in part by a physical therapist assistant",
"equivalence": "equivalent"
} ],
"display": "Outpatient physical therapy services furnished in whole or in part by a physical therapist assistant"
}, {
"code": "CR",
"target": [ {
"code": "CR",
"comment": "exact match",
"display": "Catastrophe/disaster related",
"equivalence": "equivalent"
} ],
"display": "Catastrophe/disaster related"
}, {
"code": "CS",
"target": [ {
"code": "1021910",
"comment": "exact match",
"display": "Level II (HCPCS/National) Modifiers",
"equivalence": "equivalent"
} ],
"display": "Cost-sharing waived for specified covid-19 testing-related services that result in and order for or administration of a covid-19 test and/or used for cost-sharing waived preventive services furnished via telehealth in rural health clinics and federally qualified health centers during the covid-19 public health emergency"
}, {
"code": "CT",
"target": [ {
"code": "CT",
"comment": "exact match",
"display": "Computed tomography services furnished using equipment that does not meet each of the attributes of the national electrical manufacturers association (nema) xr-29-2013 standard",
"equivalence": "equivalent"
} ],
"display": "Computed tomography services furnished using equipment that does not meet each of the attributes of the national electrical manufacturers association (nema) xr-29-2013 standard"
}, {
"code": "DA",
"target": [ {
"code": "DA",
"comment": "exact match",
"display": "Oral health assessment by a licensed health professional other than a dentist",
"equivalence": "equivalent"
} ],
"display": "Oral health assessment by a licensed health professional other than a dentist"
}, {
"code": "E1",
"target": [ {
"code": "E1",
"comment": "exact match",
"display": "Upper left, eyelid",
"equivalence": "equivalent"
} ],
"display": "Upper left, eyelid"
}, {
"code": "E2",
"target": [ {
"code": "E2",
"comment": "exact match",
"display": "Lower left, eyelid",
"equivalence": "equivalent"
} ],
"display": "Lower left, eyelid"
}, {
"code": "E3",
"target": [ {
"code": "E3",
"comment": "exact match",
"display": "Upper right, eyelid",
"equivalence": "equivalent"
} ],
"display": "Upper right, eyelid"
}, {
"code": "E4",
"target": [ {
"code": "E4",
"comment": "exact match",
"display": "Lower right, eyelid",
"equivalence": "equivalent"
} ],
"display": "Lower right, eyelid"
}, {
"code": "EA",
"target": [ {
"code": "EA",
"comment": "exact match",
"display": "Erythropoetic stimulating agent (esa) administered to treat anemia due to anti-cancer chemotherapy",
"equivalence": "equivalent"
} ],
"display": "Erythropoetic stimulating agent (esa) administered to treat anemia due to anti-cancer chemotherapy"
}, {
"code": "EB",
"target": [ {
"code": "EB",
"comment": "exact match",
"display": "Erythropoetic stimulating agent (esa) administered to treat anemia due to anti-cancer radiotherapy",
"equivalence": "equivalent"
} ],
"display": "Erythropoetic stimulating agent (esa) administered to treat anemia due to anti-cancer radiotherapy"
}, {
"code": "EC",
"target": [ {
"code": "EC",
"comment": "exact match",
"display": "Erythropoetic stimulating agent (esa) administered to treat anemia not due to anti-cancer radiotherapy or anti-cancer chemotherapy",
"equivalence": "equivalent"
} ],
"display": "Erythropoetic stimulating agent (esa) administered to treat anemia not due to anti-cancer radiotherapy or anti-cancer chemotherapy"
}, {
"code": "ED",
"target": [ {
"code": "ED",
"comment": "exact match",
"display": "Hematocrit level has exceeded 39% (or hemoglobin level has exceeded 13.0 g/dl) for 3 or more consecutive billing cycles immediately prior to and including the current cycle",
"equivalence": "equivalent"
} ],
"display": "Hematocrit level has exceeded 39% (or hemoglobin level has exceeded 13.0 g/dl) for 3 or more consecutive billing cycles immediately prior to and including the current cycle"
}, {
"code": "EE",
"target": [ {
"code": "EE",
"comment": "exact match",
"display": "Hematocrit level has not exceeded 39% (or hemoglobin level has not exceeded 13.0 g/dl) for 3 or more consecutive billing cycles immediately prior to and including the current cycle",
"equivalence": "equivalent"
} ],
"display": "Hematocrit level has not exceeded 39% (or hemoglobin level has not exceeded 13.0 g/dl) for 3 or more consecutive billing cycles immediately prior to and including the current cycle"
}, {
"code": "EJ",
"target": [ {
"code": "EJ",
"comment": "exact match",
"display": "Subsequent claims for a defined course of therapy, e.g., epo, sodium hyaluronate, infliximab",
"equivalence": "equivalent"
} ],
"display": "Subsequent claims for a defined course of therapy, e.g., epo, sodium hyaluronate, infliximab"
}, {
"code": "EM",
"target": [ {
"code": "EM",
"comment": "exact match",
"display": "Emergency reserve supply (for esrd benefit only)",
"equivalence": "equivalent"
} ],
"display": "Emergency reserve supply (for esrd benefit only)"
}, {
"code": "EP",
"target": [ {
"code": "EP",
"comment": "exact match",
"display": "Service provided as part of medicaid early periodic screening diagnosis and treatment (epsdt) program",
"equivalence": "equivalent"
} ],
"display": "Service provided as part of medicaid early periodic screening diagnosis and treatment (epsdt) program"
}, {
"code": "ER",
"target": [ {
"code": "ER",
"comment": "exact match",
"display": "Items and services furnished by a provider-based, off-campus emergency department",
"equivalence": "equivalent"
} ],
"display": "Items and services furnished by a provider-based, off-campus emergency department"
}, {
"code": "ET",
"target": [ {
"code": "ET",
"comment": "exact match",
"display": "Emergency services",
"equivalence": "equivalent"
} ],
"display": "Emergency services"
}, {
"code": "EX",
"target": [ {
"code": "EX",
"comment": "exact match",
"display": "Expatriate beneficiary",
"equivalence": "equivalent"
} ],
"display": "Expatriate beneficiary"
}, {
"code": "EY",
"target": [ {
"code": "EY",
"comment": "exact match",
"display": "No physician or other licensed health care provider order for this item or service",
"equivalence": "equivalent"
} ],
"display": "No physician or other licensed health care provider order for this item or service"
}, {
"code": "F1",
"target": [ {
"code": "F1",
"comment": "exact match",
"display": "Left hand, second digit",
"equivalence": "equivalent"
} ],
"display": "Left hand, second digit"
}, {
"code": "F2",
"target": [ {
"code": "F2",
"comment": "exact match",
"display": "Left hand, third digit",
"equivalence": "equivalent"
} ],
"display": "Left hand, third digit"
}, {
"code": "F3",
"target": [ {
"code": "F3",
"comment": "exact match",
"display": "Left hand, fourth digit",
"equivalence": "equivalent"
} ],
"display": "Left hand, fourth digit"
}, {
"code": "F4",
"target": [ {
"code": "F4",
"comment": "exact match",
"display": "Left hand, fifth digit",
"equivalence": "equivalent"
} ],
"display": "Left hand, fifth digit"
}, {
"code": "F5",
"target": [ {
"code": "F5",
"comment": "exact match",
"display": "Right hand, thumb",
"equivalence": "equivalent"
} ],
"display": "Right hand, thumb"
}, {
"code": "F6",
"target": [ {
"code": "F6",
"comment": "exact match",
"display": "Right hand, second digit",
"equivalence": "equivalent"
} ],
"display": "Right hand, second digit"
}, {
"code": "F7",
"target": [ {
"code": "F7",
"comment": "exact match",
"display": "Right hand, third digit",
"equivalence": "equivalent"
} ],
"display": "Right hand, third digit"
}, {
"code": "F8",
"target": [ {
"code": "F8",
"comment": "exact match",
"display": "Right hand, fourth digit",
"equivalence": "equivalent"
} ],
"display": "Right hand, fourth digit"
}, {
"code": "F9",
"target": [ {
"code": "F9",
"comment": "exact match",
"display": "Right hand, fifth digit",
"equivalence": "equivalent"
} ],
"display": "Right hand, fifth digit"
}, {
"code": "FA",
"target": [ {
"code": "FA",
"comment": "exact match",
"display": "Left hand, thumb",
"equivalence": "equivalent"
} ],
"display": "Left hand, thumb"
}, {
"code": "FB",
"target": [ {
"code": "FB",
"comment": "exact match",
"display": "Item provided without cost to provider, supplier or practitioner, or full credit received for replaced device (examples, but not limited to, covered under warranty, replaced due to defect, free samples)",
"equivalence": "equivalent"
} ],
"display": "Item provided without cost to provider, supplier or practitioner, or full credit received for replaced device (examples, but not limited to, covered under warranty, replaced due to defect, free samples)"
}, {
"code": "FC",
"target": [ {
"code": "FC",
"comment": "exact match",
"display": "Partial credit received for replaced device",
"equivalence": "equivalent"
} ],
"display": "Partial credit received for replaced device"
}, {
"code": "FP",
"target": [ {
"code": "FP",
"comment": "exact match",
"display": "Service provided as part of family planning program",
"equivalence": "equivalent"
} ],
"display": "Service provided as part of family planning program"
}, {
"code": "FX",
"target": [ {
"code": "FX",
"comment": "exact match",
"display": "X-ray taken using film",
"equivalence": "equivalent"
} ],
"display": "X-ray taken using film"
}, {
"code": "FY",
"target": [ {
"code": "FY",
"comment": "exact match",
"display": "X-ray taken using computed radiography technology/cassette-based imaging",
"equivalence": "equivalent"
} ],
"display": "X-ray taken using computed radiography technology/cassette-based imaging"
}, {
"code": "G0",
"target": [ {
"code": "G0",
"comment": "exact match",
"display": "Telehealth services for diagnosis, evaluation, or treatment, of symptoms of an acute stroke",
"equivalence": "equivalent"
} ],
"display": "Telehealth services for diagnosis, evaluation, or treatment, of symptoms of an acute stroke"
}, {
"code": "G1",
"target": [ {
"code": "G1",
"comment": "exact match",
"display": "Most recent urr reading of less than 60",
"equivalence": "equivalent"
} ],
"display": "Most recent urr reading of less than 60"
}, {
"code": "G2",
"target": [ {
"code": "G2",
"comment": "exact match",
"display": "Most recent urr reading of 60 to 64.9",
"equivalence": "equivalent"
} ],
"display": "Most recent urr reading of 60 to 64.9"
}, {
"code": "G3",
"target": [ {
"code": "G3",
"comment": "exact match",
"display": "Most recent urr reading of 65 to 69.9",
"equivalence": "equivalent"
} ],
"display": "Most recent urr reading of 65 to 69.9"
}, {
"code": "G4",
"target": [ {
"code": "G4",
"comment": "exact match",
"display": "Most recent urr reading of 70 to 74.9",
"equivalence": "equivalent"
} ],
"display": "Most recent urr reading of 70 to 74.9"
}, {
"code": "G5",
"target": [ {
"code": "G5",
"comment": "exact match",
"display": "Most recent urr reading of 75 or greater",
"equivalence": "equivalent"
} ],
"display": "Most recent urr reading of 75 or greater"
}, {
"code": "G6",
"target": [ {
"code": "G6",
"comment": "exact match",
"display": "Esrd patient for whom less than six dialysis sessions have been provided in a month",
"equivalence": "equivalent"
} ],
"display": "Esrd patient for whom less than six dialysis sessions have been provided in a month"
}, {
"code": "G7",
"target": [ {
"code": "G7",
"comment": "exact match",
"display": "Pregnancy resulted from rape or incest or pregnancy certified by physician as life threatening",
"equivalence": "equivalent"
} ],
"display": "Pregnancy resulted from rape or incest or pregnancy certified by physician as life threatening"
}, {
"code": "G8",
"target": [ {
"code": "G8",
"comment": "exact match",
"display": "Monitored anesthesia care (mac) for deep complex, complicated, or markedly invasive surgical procedure",
"equivalence": "equivalent"
} ],
"display": "Monitored anesthesia care (mac) for deep complex, complicated, or markedly invasive surgical procedure"
}, {
"code": "G9",
"target": [ {
"code": "G9",
"comment": "exact match",
"display": "Monitored anesthesia care for patient who has history of severe cardio-pulmonary condition",
"equivalence": "equivalent"
} ],
"display": "Monitored anesthesia care for patient who has history of severe cardio-pulmonary condition"
}, {
"code": "GA",
"target": [ {
"code": "GA",
"comment": "exact match",
"display": "Waiver of liability statement issued as required by payer policy, individual case",
"equivalence": "equivalent"
} ],
"display": "Waiver of liability statement issued as required by payer policy, individual case"
}, {
"code": "GB",
"target": [ {
"code": "GB",
"comment": "exact match",
"display": "Claim being re-submitted for payment because it is no longer covered under a global payment demonstration",
"equivalence": "equivalent"
} ],
"display": "Claim being re-submitted for payment because it is no longer covered under a global payment demonstration"
}, {
"code": "GC",
"target": [ {
"code": "GC",
"comment": "exact match",
"display": "This service has been performed in part by a resident under the direction of a teaching physician",
"equivalence": "equivalent"
} ],
"display": "This service has been performed in part by a resident under the direction of a teaching physician"
}, {
"code": "GE",
"target": [ {
"code": "GE",
"comment": "exact match",
"display": "This service has been performed by a resident without the presence of a teaching physician under the primary care exception",
"equivalence": "equivalent"
} ],
"display": "This service has been performed by a resident without the presence of a teaching physician under the primary care exception"
}, {
"code": "GF",
"target": [ {
"code": "GF",
"comment": "exact match",
"display": "Non-physician (e.g. nurse practitioner (np), certified registered nurse anesthetist (crna), certified registered nurse (crn), clinical nurse specialist (cns), physician assistant (pa)) services in a critical access hospital",
"equivalence": "equivalent"
} ],
"display": "Non-physician (e.g. nurse practitioner (np), certified registered nurse anesthetist (crna), certified registered nurse (crn), clinical nurse specialist (cns), physician assistant (pa)) services in a critical access hospital"
}, {
"code": "GG",
"target": [ {
"code": "GG",
"comment": "exact match",
"display": "Performance and payment of a screening mammogram and diagnostic mammogram on the same patient, same day",
"equivalence": "equivalent"
} ],
"display": "Performance and payment of a screening mammogram and diagnostic mammogram on the same patient, same day"
}, {
"code": "GH",
"target": [ {
"code": "GH",
"comment": "exact match",
"display": "Diagnostic mammogram converted from screening mammogram on same day",
"equivalence": "equivalent"
} ],
"display": "Diagnostic mammogram converted from screening mammogram on same day"
}, {
"code": "GJ",
"target": [ {
"code": "GJ",
"comment": "exact match",
"display": "\"opt out\" physician or practitioner emergency or urgent service",
"equivalence": "equivalent"
} ],
"display": "\"opt out\" physician or practitioner emergency or urgent service"
}, {
"code": "GK",
"target": [ {
"code": "GK",
"comment": "exact match",
"display": "Reasonable and necessary item/service associated with a ga or gz modifier",
"equivalence": "equivalent"
} ],
"display": "Reasonable and necessary item/service associated with a ga or gz modifier"
}, {
"code": "GL",
"target": [ {
"code": "GL",
"comment": "exact match",
"display": "Medically unnecessary upgrade provided instead of non-upgraded item, no charge, no advance beneficiary notice (abn)",
"equivalence": "equivalent"
} ],
"display": "Medically unnecessary upgrade provided instead of non-upgraded item, no charge, no advance beneficiary notice (abn)"
}, {
"code": "GM",
"target": [ {
"code": "GM",
"comment": "exact match",
"display": "Multiple patients on one ambulance trip",
"equivalence": "equivalent"
} ],
"display": "Multiple patients on one ambulance trip"
}, {
"code": "GN",
"target": [ {
"code": "GN",
"comment": "exact match",
"display": "Services delivered under an outpatient speech language pathology plan of care",
"equivalence": "equivalent"
} ],
"display": "Services delivered under an outpatient speech language pathology plan of care"
}, {
"code": "GO",
"target": [ {
"code": "GO",
"comment": "exact match",
"display": "Services delivered under an outpatient occupational therapy plan of care",
"equivalence": "equivalent"
} ],
"display": "Services delivered under an outpatient occupational therapy plan of care"
}, {
"code": "GP",
"target": [ {
"code": "GP",
"comment": "exact match",
"display": "Services delivered under an outpatient physical therapy plan of care",
"equivalence": "equivalent"
} ],
"display": "Services delivered under an outpatient physical therapy plan of care"
}, {
"code": "GQ",
"target": [ {
"code": "GQ",
"comment": "exact match",
"display": "Via asynchronous telecommunications system",
"equivalence": "equivalent"
} ],
"display": "Via asynchronous telecommunications system"
}, {
"code": "GR",
"target": [ {
"code": "GR",
"comment": "exact match",
"display": "This service was performed in whole or in part by a resident in a department of veterans affairs medical center or clinic, supervised in accordance with va policy",
"equivalence": "equivalent"
} ],
"display": "This service was performed in whole or in part by a resident in a department of veterans affairs medical center or clinic, supervised in accordance with va policy"
}, {
"code": "GS",
"target": [ {
"code": "GS",
"comment": "exact match",
"display": "Dosage of erythropoietin stimulating agent has been reduced and maintained in response to hematocrit or hemoglobin level",
"equivalence": "equivalent"
} ],
"display": "Dosage of erythropoietin stimulating agent has been reduced and maintained in response to hematocrit or hemoglobin level"
}, {
"code": "GT",
"target": [ {
"code": "GT",
"comment": "exact match",
"display": "Via interactive audio and video telecommunication systems",
"equivalence": "equivalent"
} ],
"display": "Via interactive audio and video telecommunication systems"
}, {
"code": "GU",
"target": [ {
"code": "GU",
"comment": "exact match",
"display": "Waiver of liability statement issued as required by payer policy, routine notice",
"equivalence": "equivalent"
} ],
"display": "Waiver of liability statement issued as required by payer policy, routine notice"
}, {
"code": "GV",
"target": [ {
"code": "GV",
"comment": "exact match",
"display": "Attending physician not employed or paid under arrangement by the patient's hospice provider",
"equivalence": "equivalent"
} ],
"display": "Attending physician not employed or paid under arrangement by the patient's hospice provider"
}, {
"code": "GW",
"target": [ {
"code": "GW",
"comment": "exact match",
"display": "Service not related to the hospice patient's terminal condition",
"equivalence": "equivalent"
} ],
"display": "Service not related to the hospice patient's terminal condition"
}, {
"code": "GX",
"target": [ {
"code": "GX",
"comment": "exact match",
"display": "Notice of liability issued, voluntary under payer policy",
"equivalence": "equivalent"
} ],
"display": "Notice of liability issued, voluntary under payer policy"
}, {
"code": "GY",
"target": [ {
"code": "GY",
"comment": "exact match",
"display": "Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit",
"equivalence": "equivalent"
} ],
"display": "Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit"
}, {
"code": "GZ",
"target": [ {
"code": "GZ",
"comment": "exact match",
"display": "Item or service expected to be denied as not reasonable and necessary",
"equivalence": "equivalent"
} ],
"display": "Item or service expected to be denied as not reasonable and necessary"
}, {
"code": "H9",
"target": [ {
"code": "H9",
"comment": "exact match",
"display": "Court-ordered",
"equivalence": "equivalent"
} ],
"display": "Court-ordered"
}, {
"code": "HA",
"target": [ {
"code": "HA",
"comment": "exact match",
"display": "Child/adolescent program",
"equivalence": "equivalent"
} ],
"display": "Child/adolescent program"
}, {
"code": "HB",
"target": [ {
"code": "HB",
"comment": "exact match",
"display": "Adult program, non geriatric",
"equivalence": "equivalent"
} ],
"display": "Adult program, non geriatric"
}, {
"code": "HC",
"target": [ {
"code": "HC",
"comment": "exact match",
"display": "Adult program, geriatric",
"equivalence": "equivalent"
} ],
"display": "Adult program, geriatric"
}, {
"code": "HD",
"target": [ {
"code": "HD",
"comment": "exact match",
"display": "Pregnant/parenting women's program",
"equivalence": "equivalent"
} ],
"display": "Pregnant/parenting women's program"
}, {
"code": "HE",
"target": [ {
"code": "HE",
"comment": "exact match",
"display": "Mental health program",
"equivalence": "equivalent"
} ],
"display": "Mental health program"
}, {
"code": "HF",
"target": [ {
"code": "HF",
"comment": "exact match",
"display": "Substance abuse program",
"equivalence": "equivalent"
} ],
"display": "Substance abuse program"
}, {
"code": "HG",
"target": [ {
"code": "HG",
"comment": "exact match",
"display": "Opioid addiction treatment program",
"equivalence": "equivalent"
} ],
"display": "Opioid addiction treatment program"
}, {
"code": "HH",
"target": [ {
"code": "HH",
"comment": "exact match",
"display": "Integrated mental health/substance abuse program",
"equivalence": "equivalent"
} ],
"display": "Integrated mental health/substance abuse program"
}, {
"code": "HI",
"target": [ {
"code": "HI",
"comment": "exact match",
"display": "Integrated mental health and intellectual disability/developmental disabilities program",
"equivalence": "equivalent"
} ],
"display": "Integrated mental health and intellectual disability/developmental disabilities program"
}, {
"code": "HJ",
"target": [ {
"code": "HJ",
"comment": "exact match",
"display": "Employee assistance program",
"equivalence": "equivalent"
} ],
"display": "Employee assistance program"
}, {
"code": "HK",
"target": [ {
"code": "HK",
"comment": "exact match",
"display": "Specialized mental health programs for high-risk populations",
"equivalence": "equivalent"
} ],
"display": "Specialized mental health programs for high-risk populations"
}, {
"code": "HL",
"target": [ {
"code": "HL",
"comment": "exact match",
"display": "Intern",
"equivalence": "equivalent"
} ],
"display": "Intern"
}, {
"code": "HM",
"target": [ {
"code": "HM",
"comment": "exact match",
"display": "Less than bachelor degree level",
"equivalence": "equivalent"
} ],
"display": "Less than bachelor degree level"
}, {
"code": "HN",
"target": [ {
"code": "HN",
"comment": "exact match",
"display": "Bachelors degree level",
"equivalence": "equivalent"
} ],
"display": "Bachelors degree level"
}, {
"code": "HO",
"target": [ {
"code": "HO",
"comment": "exact match",
"display": "Masters degree level",
"equivalence": "equivalent"
} ],
"display": "Masters degree level"
}, {
"code": "HP",
"target": [ {
"code": "HP",
"comment": "exact match",
"display": "Doctoral level",
"equivalence": "equivalent"
} ],
"display": "Doctoral level"
}, {
"code": "HQ",
"target": [ {
"code": "HQ",
"comment": "exact match",
"display": "Group setting",
"equivalence": "equivalent"
} ],
"display": "Group setting"
}, {
"code": "HR",
"target": [ {
"code": "HR",
"comment": "exact match",
"display": "Family/couple with client present",
"equivalence": "equivalent"
} ],
"display": "Family/couple with client present"
}, {
"code": "HS",
"target": [ {
"code": "HS",
"comment": "exact match",
"display": "Family/couple without client present",
"equivalence": "equivalent"
} ],
"display": "Family/couple without client present"
}, {
"code": "HT",
"target": [ {
"code": "HT",
"comment": "exact match",
"display": "Multi-disciplinary team",
"equivalence": "equivalent"
} ],
"display": "Multi-disciplinary team"
}, {
"code": "HU",
"target": [ {
"code": "HU",
"comment": "exact match",
"display": "Funded by child welfare agency",
"equivalence": "equivalent"
} ],
"display": "Funded by child welfare agency"
}, {
"code": "HV",
"target": [ {
"code": "HV",
"comment": "exact match",
"display": "Funded state addictions agency",
"equivalence": "equivalent"
} ],
"display": "Funded state addictions agency"
}, {
"code": "HW",
"target": [ {
"code": "HW",
"comment": "exact match",
"display": "Funded by state mental health agency",
"equivalence": "equivalent"
} ],
"display": "Funded by state mental health agency"
}, {
"code": "HX",
"target": [ {
"code": "HX",
"comment": "exact match",
"display": "Funded by county/local agency",
"equivalence": "equivalent"
} ],
"display": "Funded by county/local agency"
}, {
"code": "HY",
"target": [ {
"code": "HY",
"comment": "exact match",
"display": "Funded by juvenile justice agency",
"equivalence": "equivalent"
} ],
"display": "Funded by juvenile justice agency"
}, {
"code": "HZ",
"target": [ {
"code": "HZ",
"comment": "exact match",
"display": "Funded by criminal justice agency",
"equivalence": "equivalent"
} ],
"display": "Funded by criminal justice agency"
}, {
"code": "J1",
"target": [ {
"code": "J1",
"comment": "exact match",
"display": "Competitive acquisition program no-pay submission for a prescription number",
"equivalence": "equivalent"
} ],
"display": "Competitive acquisition program no-pay submission for a prescription number"
}, {
"code": "J2",
"target": [ {
"code": "J2",
"comment": "exact match",
"display": "Competitive acquisition program, restocking of emergency drugs after emergency administration",
"equivalence": "equivalent"
} ],
"display": "Competitive acquisition program, restocking of emergency drugs after emergency administration"
}, {
"code": "J3",
"target": [ {
"code": "J3",
"comment": "exact match",
"display": "Competitive acquisition program (cap), drug not available through cap as written, reimbursed under average sales price methodology",
"equivalence": "equivalent"
} ],
"display": "Competitive acquisition program (cap), drug not available through cap as written, reimbursed under average sales price methodology"
}, {
"code": "J4",
"target": [ {
"code": "J4",
"comment": "exact match",
"display": "Dmepos item subject to dmepos competitive bidding program that is furnished by a hospital upon discharge",
"equivalence": "equivalent"
} ],
"display": "Dmepos item subject to dmepos competitive bidding program that is furnished by a hospital upon discharge"
}, {
"code": "J5",
"target": [ {
"code": "1021910",
"comment": "exact match",
"display": "Level II (HCPCS/National) Modifiers",
"equivalence": "equivalent"
} ],
"display": "Off-the-shelf orthotic subject to dmepos competitive bidding program that is furnished as part of a physical therapist or occupational therapist professional service"
}, {
"code": "JA",
"target": [ {
"code": "JA",
"comment": "exact match",
"display": "Administered intravenously",
"equivalence": "equivalent"
} ],
"display": "Administered intravenously"
}, {
"code": "JB",
"target": [ {
"code": "JB",
"comment": "exact match",
"display": "Administered subcutaneously",
"equivalence": "equivalent"
} ],
"display": "Administered subcutaneously"
}, {
"code": "JC",
"target": [ {
"code": "JC",
"comment": "exact match",
"display": "Skin substitute used as a graft",
"equivalence": "equivalent"
} ],
"display": "Skin substitute used as a graft"
}, {
"code": "JC",
"target": [ {
"code": "1020888",
"comment": "exact match",
"display": "Skin Substitute Grafts",
"equivalence": "equivalent"
} ],
"display": "Skin substitute used as a graft"
}, {
"code": "JD",
"target": [ {
"code": "JD",
"comment": "exact match",
"display": "Skin substitute not used as a graft",
"equivalence": "equivalent"
} ],
"display": "Skin substitute not used as a graft"
}, {
"code": "JE",
"target": [ {
"code": "JE",
"comment": "exact match",
"display": "Administered via dialysate",
"equivalence": "equivalent"
} ],
"display": "Administered via dialysate"
}, {
"code": "JG",
"target": [ {
"code": "JG",
"comment": "exact match",
"display": "Drug or biological acquired with 340b drug pricing program discount",
"equivalence": "equivalent"
} ],
"display": "Drug or biological acquired with 340b drug pricing program discount"
}, {
"code": "JW",
"target": [ {
"code": "JW",
"comment": "exact match",
"display": "Drug amount discarded/not administered to any patient",
"equivalence": "equivalent"
} ],
"display": "Drug amount discarded/not administered to any patient"
}, {
"code": "K0",
"target": [ {
"code": "K0",
"comment": "exact match",
"display": "Lower extremity prosthesis functional level 0 - does not have the ability or potential to ambulate or transfer safely with or without assistance and a prosthesis does not enhance their quality of life or mobility.",
"equivalence": "equivalent"
} ],
"display": "Lower extremity prosthesis functional level 0 - does not have the ability or potential to ambulate or transfer safely with or without assistance and a prosthesis does not enhance their quality of life or mobility."
}, {
"code": "K1",
"target": [ {
"code": "K1",
"comment": "exact match",
"display": "Lower extremity prosthesis functional level 1 - has the ability or potential to use a prosthesis for transfers or ambulation on level surfaces at fixed cadence. typical of the limited and unlimited household ambulator.",
"equivalence": "equivalent"
} ],
"display": "Lower extremity prosthesis functional level 1 - has the ability or potential to use a prosthesis for transfers or ambulation on level surfaces at fixed cadence. typical of the limited and unlimited household ambulator."
}, {
"code": "K2",
"target": [ {
"code": "K2",
"comment": "exact match",
"display": "Lower extremity prosthesis functional level 2 - has the ability or potential for ambulation with the ability to traverse low level environmental barriers such as curbs, stairs or uneven surfaces. typical of the limited community ambulator.",
"equivalence": "equivalent"
} ],
"display": "Lower extremity prosthesis functional level 2 - has the ability or potential for ambulation with the ability to traverse low level environmental barriers such as curbs, stairs or uneven surfaces. typical of the limited community ambulator."
}, {
"code": "K3",
"target": [ {
"code": "K3",
"comment": "exact match",
"display": "Lower extremity prosthesis functional level 3 - has the ability or potential for ambulation with variable cadence. typical of the community ambulator who has the ability to transverse most environmental barriers and may have vocational, therapeutic, or exercise activity that demands prosthetic utilization beyond simple locomotion.",
"equivalence": "equivalent"
} ],
"display": "Lower extremity prosthesis functional level 3 - has the ability or potential for ambulation with variable cadence. typical of the community ambulator who has the ability to transverse most environmental barriers and may have vocational, therapeutic, or exercise activity that demands prosthetic utilization beyond simple locomotion."
}, {
"code": "K4",
"target": [ {
"code": "K4",
"comment": "exact match",
"display": "Lower extremity prosthesis functional level 4 - has the ability or potential for prosthetic ambulation that exceeds the basic ambulation skills, exhibiting high impact, stress, or energy levels, typical of the prosthetic demands of the child, active adult, or athlete.",
"equivalence": "equivalent"
} ],
"display": "Lower extremity prosthesis functional level 4 - has the ability or potential for prosthetic ambulation that exceeds the basic ambulation skills, exhibiting high impact, stress, or energy levels, typical of the prosthetic demands of the child, active adult, or athlete."
}, {
"code": "KA",
"target": [ {
"code": "KA",
"comment": "exact match",
"display": "Add on option/accessory for wheelchair",
"equivalence": "equivalent"
} ],
"display": "Add on option/accessory for wheelchair"
}, {
"code": "KB",
"target": [ {
"code": "KB",
"comment": "exact match",
"display": "Beneficiary requested upgrade for abn, more than 4 modifiers identified on claim",
"equivalence": "equivalent"
} ],
"display": "Beneficiary requested upgrade for abn, more than 4 modifiers identified on claim"
}, {
"code": "KC",
"target": [ {
"code": "KC",
"comment": "exact match",
"display": "Replacement of special power wheelchair interface",
"equivalence": "equivalent"
} ],
"display": "Replacement of special power wheelchair interface"
}, {
"code": "KD",
"target": [ {
"code": "KD",
"comment": "exact match",
"display": "Drug or biological infused through dme",
"equivalence": "equivalent"
} ],
"display": "Drug or biological infused through dme"
}, {
"code": "KE",
"target": [ {
"code": "KE",
"comment": "exact match",
"display": "Bid under round one of the dmepos competitive bidding program for use with non-competitive bid base equipment",
"equivalence": "equivalent"
} ],
"display": "Bid under round one of the dmepos competitive bidding program for use with non-competitive bid base equipment"
}, {
"code": "KF",
"target": [ {
"code": "KF",
"comment": "exact match",
"display": "Item designated by fda as class iii device",
"equivalence": "equivalent"
} ],
"display": "Item designated by fda as class iii device"
}, {
"code": "KG",
"target": [ {
"code": "KG",
"comment": "exact match",
"display": "Dmepos item subject to dmepos competitive bidding program number 1",
"equivalence": "equivalent"
} ],
"display": "Dmepos item subject to dmepos competitive bidding program number 1"
}, {
"code": "KH",
"target": [ {
"code": "KH",
"comment": "exact match",
"display": "Dmepos item, initial claim, purchase or first month rental",
"equivalence": "equivalent"
} ],
"display": "Dmepos item, initial claim, purchase or first month rental"
}, {
"code": "KI",
"target": [ {
"code": "KI",
"comment": "exact match",
"display": "Dmepos item, second or third month rental",
"equivalence": "equivalent"
} ],
"display": "Dmepos item, second or third month rental"
}, {
"code": "KJ",
"target": [ {
"code": "KJ",
"comment": "exact match",
"display": "Dmepos item, parenteral enteral nutrition (pen) pump or capped rental, months four to fifteen",
"equivalence": "equivalent"
} ],
"display": "Dmepos item, parenteral enteral nutrition (pen) pump or capped rental, months four to fifteen"
}, {
"code": "KK",
"target": [ {
"code": "KK",
"comment": "exact match",
"display": "Dmepos item subject to dmepos competitive bidding program number 2",
"equivalence": "equivalent"
} ],
"display": "Dmepos item subject to dmepos competitive bidding program number 2"
}, {
"code": "KL",
"target": [ {
"code": "KL",
"comment": "exact match",
"display": "Dmepos item delivered via mail",
"equivalence": "equivalent"
} ],
"display": "Dmepos item delivered via mail"
}, {
"code": "KM",
"target": [ {
"code": "KM",
"comment": "exact match",
"display": "Replacement of facial prosthesis including new impression/moulage",
"equivalence": "equivalent"
} ],
"display": "Replacement of facial prosthesis including new impression/moulage"
}, {
"code": "KN",
"target": [ {
"code": "KN",
"comment": "exact match",
"display": "Replacement of facial prosthesis using previous master model",
"equivalence": "equivalent"
} ],
"display": "Replacement of facial prosthesis using previous master model"
}, {
"code": "KO",
"target": [ {
"code": "KO",
"comment": "exact match",
"display": "Single drug unit dose formulation",
"equivalence": "equivalent"
} ],
"display": "Single drug unit dose formulation"
}, {
"code": "KP",
"target": [ {
"code": "KP",
"comment": "exact match",
"display": "First drug of a multiple drug unit dose formulation",
"equivalence": "equivalent"
} ],
"display": "First drug of a multiple drug unit dose formulation"
}, {
"code": "KQ",
"target": [ {
"code": "KQ",
"comment": "exact match",
"display": "Second or subsequent drug of a multiple drug unit dose formulation",
"equivalence": "equivalent"
} ],
"display": "Second or subsequent drug of a multiple drug unit dose formulation"
}, {
"code": "KR",
"target": [ {
"code": "KR",
"comment": "exact match",
"display": "Rental item, billing for partial month",
"equivalence": "equivalent"
} ],
"display": "Rental item, billing for partial month"
}, {
"code": "KS",
"target": [ {
"code": "KS",
"comment": "exact match",
"display": "Glucose monitor supply for diabetic beneficiary not treated with insulin",
"equivalence": "equivalent"
} ],
"display": "Glucose monitor supply for diabetic beneficiary not treated with insulin"
}, {
"code": "KT",
"target": [ {
"code": "KT",
"comment": "exact match",
"display": "Beneficiary resides in a competitive bidding area and travels outside that competitive bidding area and receives a competitive bid item",
"equivalence": "equivalent"
} ],
"display": "Beneficiary resides in a competitive bidding area and travels outside that competitive bidding area and receives a competitive bid item"
}, {
"code": "KU",
"target": [ {
"code": "KU",
"comment": "exact match",
"display": "Dmepos item subject to dmepos competitive bidding program number 3",
"equivalence": "equivalent"
} ],
"display": "Dmepos item subject to dmepos competitive bidding program number 3"
}, {
"code": "KV",
"target": [ {
"code": "KV",
"comment": "exact match",
"display": "Dmepos item subject to dmepos competitive bidding program that is furnished as part of a professional service",
"equivalence": "equivalent"
} ],
"display": "Dmepos item subject to dmepos competitive bidding program that is furnished as part of a professional service"
}, {
"code": "KW",
"target": [ {
"code": "KW",
"comment": "exact match",
"display": "Dmepos item subject to dmepos competitive bidding program number 4",
"equivalence": "equivalent"
} ],
"display": "Dmepos item subject to dmepos competitive bidding program number 4"
}, {
"code": "KX",
"target": [ {
"code": "KX",
"comment": "exact match",
"display": "Requirements specified in the medical policy have been met",
"equivalence": "equivalent"
} ],
"display": "Requirements specified in the medical policy have been met"
}, {
"code": "KY",
"target": [ {
"code": "KY",
"comment": "exact match",
"display": "Dmepos item subject to dmepos competitive bidding program number 5",
"equivalence": "equivalent"
} ],
"display": "Dmepos item subject to dmepos competitive bidding program number 5"
}, {
"code": "KZ",
"target": [ {
"code": "KZ",
"comment": "exact match",
"display": "New coverage not implemented by managed care",
"equivalence": "equivalent"
} ],
"display": "New coverage not implemented by managed care"
}, {
"code": "LC",
"target": [ {
"code": "LC",
"comment": "exact match",
"display": "Left circumflex coronary artery",
"equivalence": "equivalent"
} ],
"display": "Left circumflex coronary artery"
}, {
"code": "LD",
"target": [ {
"code": "LD",
"comment": "exact match",
"display": "Left anterior descending coronary artery",
"equivalence": "equivalent"
} ],
"display": "Left anterior descending coronary artery"
}, {
"code": "LL",
"target": [ {
"code": "LL",
"comment": "exact match",
"display": "Lease/rental (use the 'll' modifier when dme equipment rental is to be applied against the purchase price)",
"equivalence": "equivalent"
} ],
"display": "Lease/rental (use the 'll' modifier when dme equipment rental is to be applied against the purchase price)"
}, {
"code": "LM",
"target": [ {
"code": "LM",
"comment": "exact match",
"display": "Left main coronary artery",
"equivalence": "equivalent"
} ],
"display": "Left main coronary artery"
}, {
"code": "LR",
"target": [ {
"code": "LR",
"comment": "exact match",
"display": "Laboratory round trip",
"equivalence": "equivalent"
} ],
"display": "Laboratory round trip"
}, {
"code": "LS",
"target": [ {
"code": "LS",
"comment": "exact match",
"display": "Fda-monitored intraocular lens implant",
"equivalence": "equivalent"
} ],
"display": "Fda-monitored intraocular lens implant"
}, {
"code": "LT",
"target": [ {
"code": "LT",
"comment": "exact match",
"display": "Left side (used to identify procedures performed on the left side of the body)",
"equivalence": "equivalent"
} ],
"display": "Left side (used to identify procedures performed on the left side of the body)"
}, {
"code": "M2",
"target": [ {
"code": "M2",
"comment": "exact match",
"display": "Medicare secondary payer (msp)",
"equivalence": "equivalent"
} ],
"display": "Medicare secondary payer (msp)"
}, {
"code": "MA",
"target": [ {
"code": "MA",
"comment": "exact match",
"display": "Ordering professional is not required to consult a clinical decision support mechanism due to service being rendered to a patient with a suspected or confirmed emergency medical condition",
"equivalence": "equivalent"
} ],
"display": "Ordering professional is not required to consult a clinical decision support mechanism due to service being rendered to a patient with a suspected or confirmed emergency medical condition"
}, {
"code": "MB",
"target": [ {
"code": "MB",
"comment": "exact match",
"display": "Ordering professional is not required to consult a clinical decision support mechanism due to the significant hardship exception of insufficient internet access",
"equivalence": "equivalent"
} ],
"display": "Ordering professional is not required to consult a clinical decision support mechanism due to the significant hardship exception of insufficient internet access"
}, {
"code": "MC",
"target": [ {
"code": "MC",
"comment": "exact match",
"display": "Ordering professional is not required to consult a clinical decision support mechanism due to the significant hardship exception of electronic health record or clinical decision support mechanism vendor issues",
"equivalence": "equivalent"
} ],
"display": "Ordering professional is not required to consult a clinical decision support mechanism due to the significant hardship exception of electronic health record or clinical decision support mechanism vendor issues"
}, {
"code": "MD",
"target": [ {
"code": "MD",
"comment": "exact match",
"display": "Ordering professional is not required to consult a clinical decision support mechanism due to the significant hardship exception of extreme and uncontrollable circumstances",
"equivalence": "equivalent"
} ],
"display": "Ordering professional is not required to consult a clinical decision support mechanism due to the significant hardship exception of extreme and uncontrollable circumstances"
}, {
"code": "ME",
"target": [ {
"code": "ME",
"comment": "exact match",
"display": "The order for this service adheres to appropriate use criteria in the clinical decision support mechanism consulted by the ordering professional",
"equivalence": "equivalent"
} ],
"display": "The order for this service adheres to appropriate use criteria in the clinical decision support mechanism consulted by the ordering professional"
}, {
"code": "MF",
"target": [ {
"code": "MF",
"comment": "exact match",
"display": "The order for this service does not adhere to the appropriate use criteria in the clinical decision support mechanism consulted by the ordering professional",
"equivalence": "equivalent"
} ],
"display": "The order for this service does not adhere to the appropriate use criteria in the clinical decision support mechanism consulted by the ordering professional"
}, {
"code": "MG",
"target": [ {
"code": "MG",
"comment": "exact match",
"display": "The order for this service does not have applicable appropriate use criteria in the qualified clinical decision support mechanism consulted by the ordering professional",
"equivalence": "equivalent"
} ],
"display": "The order for this service does not have applicable appropriate use criteria in the qualified clinical decision support mechanism consulted by the ordering professional"
}, {
"code": "MH",
"target": [ {
"code": "MH",
"comment": "exact match",
"display": "Unknown if ordering professional consulted a clinical decision support mechanism for this service, related information was not provided to the furnishing professional or provider",
"equivalence": "equivalent"
} ],
"display": "Unknown if ordering professional consulted a clinical decision support mechanism for this service, related information was not provided to the furnishing professional or provider"
}, {
"code": "MS",
"target": [ {
"code": "MS",
"comment": "exact match",
"display": "Six month maintenance and servicing fee for reasonable and necessary parts and labor which are not covered under any manufacturer or supplier warranty",
"equivalence": "equivalent"
} ],
"display": "Six month maintenance and servicing fee for reasonable and necessary parts and labor which are not covered under any manufacturer or supplier warranty"
}, {
"code": "NB",
"target": [ {
"code": "NB",
"comment": "exact match",
"display": "Nebulizer system, any type, fda-cleared for use with specific drug",
"equivalence": "equivalent"
} ],
"display": "Nebulizer system, any type, fda-cleared for use with specific drug"
}, {
"code": "NR",
"target": [ {
"code": "NR",
"comment": "exact match",
"display": "New when rented (use the 'nr' modifier when dme which was new at the time of rental is subsequently purchased)",
"equivalence": "equivalent"
} ],
"display": "New when rented (use the 'nr' modifier when dme which was new at the time of rental is subsequently purchased)"
}, {
"code": "NU",
"target": [ {
"code": "NU",
"comment": "exact match",
"display": "New equipment",
"equivalence": "equivalent"
} ],
"display": "New equipment"
}, {
"code": "P1",
"target": [ {
"code": "P1",
"comment": "exact match",
"display": "A normal healthy patient",
"equivalence": "equivalent"
} ],
"display": "A normal healthy patient"
}, {
"code": "P2",
"target": [ {
"code": "P2",
"comment": "exact match",
"display": "A patient with mild systemic disease",
"equivalence": "equivalent"
} ],
"display": "A patient with mild systemic disease"
}, {
"code": "P3",
"target": [ {
"code": "P3",
"comment": "exact match",
"display": "A patient with severe systemic disease",
"equivalence": "equivalent"
} ],
"display": "A patient with severe systemic disease"
}, {
"code": "P4",
"target": [ {
"code": "P4",
"comment": "exact match",
"display": "A patient with severe systemic disease that is a constant threat to life",
"equivalence": "equivalent"
} ],
"display": "A patient with severe systemic disease that is a constant threat to life"
}, {
"code": "P5",
"target": [ {
"code": "P5",
"comment": "exact match",
"display": "A moribund patient who is not expected to survive without the operation",
"equivalence": "equivalent"
} ],
"display": "A moribund patient who is not expected to survive without the operation"
}, {
"code": "P6",
"target": [ {
"code": "P6",
"comment": "exact match",
"display": "A declared brain-dead patient whose organs are being removed for donor purposes",
"equivalence": "equivalent"
} ],
"display": "A declared brain-dead patient whose organs are being removed for donor purposes"
}, {
"code": "PA",
"target": [ {
"code": "PA",
"comment": "exact match",
"display": "Surgical or other invasive procedure on wrong body part",
"equivalence": "equivalent"
} ],
"display": "Surgical or other invasive procedure on wrong body part"
}, {
"code": "PB",
"target": [ {
"code": "PB",
"comment": "exact match",
"display": "Surgical or other invasive procedure on wrong patient",
"equivalence": "equivalent"
} ],
"display": "Surgical or other invasive procedure on wrong patient"
}, {
"code": "PC",
"target": [ {
"code": "PC",
"comment": "exact match",
"display": "Wrong surgery or other invasive procedure on patient",
"equivalence": "equivalent"
} ],
"display": "Wrong surgery or other invasive procedure on patient"
}, {
"code": "PD",
"target": [ {
"code": "PD",
"comment": "exact match",
"display": "Diagnostic or related non diagnostic item or service provided in a wholly owned or operated entity to a patient who is admitted as an inpatient within 3 days",
"equivalence": "equivalent"
} ],
"display": "Diagnostic or related non diagnostic item or service provided in a wholly owned or operated entity to a patient who is admitted as an inpatient within 3 days"
}, {
"code": "PI",
"target": [ {
"code": "PI",
"comment": "exact match",
"display": "Positron emission tomography (pet) or pet/computed tomography (ct) to inform the initial treatment strategy of tumors that are biopsy proven or strongly suspected of being cancerous based on other diagnostic testing",
"equivalence": "equivalent"
} ],
"display": "Positron emission tomography (pet) or pet/computed tomography (ct) to inform the initial treatment strategy of tumors that are biopsy proven or strongly suspected of being cancerous based on other diagnostic testing"
}, {
"code": "PL",
"target": [ {
"code": "PL",
"comment": "exact match",
"display": "Progressive addition lenses",
"equivalence": "equivalent"
} ],
"display": "Progressive addition lenses"
}, {
"code": "PM",
"target": [ {
"code": "PM",
"comment": "exact match",
"display": "Post mortem",
"equivalence": "equivalent"
} ],
"display": "Post mortem"
}, {
"code": "PN",
"target": [ {
"code": "PN",
"comment": "exact match",
"display": "Non-excepted service provided at an off-campus, outpatient, provider-based department of a hospital",
"equivalence": "equivalent"
} ],
"display": "Non-excepted service provided at an off-campus, outpatient, provider-based department of a hospital"
}, {
"code": "PO",
"target": [ {
"code": "PO",
"comment": "exact match",
"display": "Excepted service provided at an off-campus, outpatient, provider-based department of a hospital",
"equivalence": "equivalent"
} ],
"display": "Excepted service provided at an off-campus, outpatient, provider-based department of a hospital"
}, {
"code": "PS",
"target": [ {
"code": "PS",
"comment": "exact match",
"display": "Positron emission tomography (pet) or pet/computed tomography (ct) to inform the subsequent treatment strategy of cancerous tumors when the beneficiary's treating physician determines that the pet study is needed to inform subsequent anti-tumor strategy",
"equivalence": "equivalent"
} ],
"display": "Positron emission tomography (pet) or pet/computed tomography (ct) to inform the subsequent treatment strategy of cancerous tumors when the beneficiary's treating physician determines that the pet study is needed to inform subsequent anti-tumor strategy"
}, {
"code": "PT",
"target": [ {
"code": "PT",
"comment": "exact match",
"display": "Colorectal cancer screening test; converted to diagnostic test or other procedure",
"equivalence": "equivalent"
} ],
"display": "Colorectal cancer screening test; converted to diagnostic test or other procedure"
}, {
"code": "Q0",
"target": [ {
"code": "Q0",
"comment": "exact match",
"display": "Investigational clinical service provided in a clinical research study that is in an approved clinical research study",
"equivalence": "equivalent"
} ],
"display": "Investigational clinical service provided in a clinical research study that is in an approved clinical research study"
}, {
"code": "Q1",
"target": [ {
"code": "Q1",
"comment": "exact match",
"display": "Routine clinical service provided in a clinical research study that is in an approved clinical research study",
"equivalence": "equivalent"
} ],
"display": "Routine clinical service provided in a clinical research study that is in an approved clinical research study"
}, {
"code": "Q2",
"target": [ {
"code": "Q2",
"comment": "exact match",
"display": "Demonstration procedure/service",
"equivalence": "equivalent"
} ],
"display": "Demonstration procedure/service"
}, {
"code": "Q3",
"target": [ {
"code": "Q3",
"comment": "exact match",
"display": "Live kidney donor surgery and related services",
"equivalence": "equivalent"
} ],
"display": "Live kidney donor surgery and related services"
}, {
"code": "Q4",
"target": [ {
"code": "Q4",
"comment": "exact match",
"display": "Service for ordering/referring physician qualifies as a service exemption",
"equivalence": "equivalent"
} ],
"display": "Service for ordering/referring physician qualifies as a service exemption"
}, {
"code": "Q5",
"target": [ {
"code": "Q5",
"comment": "exact match",
"display": "Service furnished under a reciprocal billing arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area",
"equivalence": "equivalent"
} ],
"display": "Service furnished under a reciprocal billing arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area"
}, {
"code": "Q6",
"target": [ {
"code": "Q6",
"comment": "exact match",
"display": "Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area",
"equivalence": "equivalent"
} ],
"display": "Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area"
}, {
"code": "Q7",
"target": [ {
"code": "Q7",
"comment": "exact match",
"display": "One class a finding",
"equivalence": "equivalent"
} ],
"display": "One class a finding"
}, {
"code": "Q8",
"target": [ {
"code": "Q8",
"comment": "exact match",
"display": "Two class b findings",
"equivalence": "equivalent"
} ],
"display": "Two class b findings"
}, {
"code": "Q9",
"target": [ {
"code": "Q9",
"comment": "exact match",
"display": "One class b and two class c findings",
"equivalence": "equivalent"
} ],
"display": "One class b and two class c findings"
}, {
"code": "QA",
"target": [ {
"code": "QA",
"comment": "exact match",
"display": "Prescribed amounts of stationary oxygen for daytime use while at rest and nighttime use differ and the average of the two amounts is less than 1 liter per minute (lpm)",
"equivalence": "equivalent"
} ],
"display": "Prescribed amounts of stationary oxygen for daytime use while at rest and nighttime use differ and the average of the two amounts is less than 1 liter per minute (lpm)"
}, {
"code": "QB",
"target": [ {
"code": "QB",
"comment": "exact match",
"display": "Prescribed amounts of stationary oxygen for daytime use while at rest and nighttime use differ and the average of the two amounts exceeds 4 liters per minute (lpm) and portable oxygen is prescribed",
"equivalence": "equivalent"
} ],
"display": "Prescribed amounts of stationary oxygen for daytime use while at rest and nighttime use differ and the average of the two amounts exceeds 4 liters per minute (lpm) and portable oxygen is prescribed"
}, {
"code": "QC",
"target": [ {
"code": "QC",
"comment": "exact match",
"display": "Single channel monitoring",
"equivalence": "equivalent"
} ],
"display": "Single channel monitoring"
}, {
"code": "QD",
"target": [ {
"code": "QD",
"comment": "exact match",
"display": "Recording and storage in solid state memory by a digital recorder",
"equivalence": "equivalent"
} ],
"display": "Recording and storage in solid state memory by a digital recorder"
}, {
"code": "QE",
"target": [ {
"code": "QE",
"comment": "exact match",
"display": "Prescribed amount of stationary oxygen while at rest is less than 1 liter per minute (lpm)",
"equivalence": "equivalent"
} ],
"display": "Prescribed amount of stationary oxygen while at rest is less than 1 liter per minute (lpm)"
}, {
"code": "QF",
"target": [ {
"code": "QF",
"comment": "exact match",
"display": "Prescribed amount of stationary oxygen while at rest exceeds 4 liters per minute (lpm) and portable oxygen is prescribed",
"equivalence": "equivalent"
} ],
"display": "Prescribed amount of stationary oxygen while at rest exceeds 4 liters per minute (lpm) and portable oxygen is prescribed"
}, {
"code": "QG",
"target": [ {
"code": "QG",
"comment": "exact match",
"display": "Prescribed amount of stationary oxygen while at rest is greater than 4 liters per minute (lpm)",
"equivalence": "equivalent"
} ],
"display": "Prescribed amount of stationary oxygen while at rest is greater than 4 liters per minute (lpm)"
}, {
"code": "QH",
"target": [ {
"code": "QH",
"comment": "exact match",
"display": "Oxygen conserving device is being used with an oxygen delivery system",
"equivalence": "equivalent"
} ],
"display": "Oxygen conserving device is being used with an oxygen delivery system"
}, {
"code": "QJ",
"target": [ {
"code": "QJ",
"comment": "exact match",
"display": "Services/items provided to a prisoner or patient in state or local custody, however the state or local government, as applicable, meets the requirements in 42 cfr 411.4 (b)",
"equivalence": "equivalent"
} ],
"display": "Services/items provided to a prisoner or patient in state or local custody, however the state or local government, as applicable, meets the requirements in 42 cfr 411.4 (b)"
}, {
"code": "QK",
"target": [ {
"code": "QK",
"comment": "exact match",
"display": "Medical direction of two, three, or four concurrent anesthesia procedures involving qualified individuals",
"equivalence": "equivalent"
} ],
"display": "Medical direction of two, three, or four concurrent anesthesia procedures involving qualified individuals"
}, {
"code": "QL",
"target": [ {
"code": "QL",
"comment": "exact match",
"display": "Patient pronounced dead after ambulance called",
"equivalence": "equivalent"
} ],
"display": "Patient pronounced dead after ambulance called"
}, {
"code": "QM",
"target": [ {
"code": "QM",
"comment": "exact match",
"display": "Ambulance service provided under arrangement by a provider of services",
"equivalence": "equivalent"
} ],
"display": "Ambulance service provided under arrangement by a provider of services"
}, {
"code": "QN",
"target": [ {
"code": "QN",
"comment": "exact match",
"display": "Ambulance service furnished directly by a provider of services",
"equivalence": "equivalent"
} ],
"display": "Ambulance service furnished directly by a provider of services"
}, {
"code": "QP",
"target": [ {
"code": "QP",
"comment": "exact match",
"display": "Documentation is on file showing that the laboratory test(s) was ordered individually or ordered as a cpt-recognized panel other than automated profile codes 80002-80019, g0058, g0059, and g0060.",
"equivalence": "equivalent"
} ],
"display": "Documentation is on file showing that the laboratory test(s) was ordered individually or ordered as a cpt-recognized panel other than automated profile codes 80002-80019, g0058, g0059, and g0060."
}, {
"code": "QQ",
"target": [ {
"code": "QQ",
"comment": "exact match",
"display": "Ordering professional consulted a qualified clinical decision support mechanism for this service and the related data was provided to the furnishing professional",
"equivalence": "equivalent"
} ],
"display": "Ordering professional consulted a qualified clinical decision support mechanism for this service and the related data was provided to the furnishing professional"
}, {
"code": "QR",
"target": [ {
"code": "QR",
"comment": "exact match",
"display": "Prescribed amounts of stationary oxygen for daytime use while at rest and nighttime use differ and the average of the two amounts is greater than 4 liters per minute (lpm)",
"equivalence": "equivalent"
} ],
"display": "Prescribed amounts of stationary oxygen for daytime use while at rest and nighttime use differ and the average of the two amounts is greater than 4 liters per minute (lpm)"
}, {
"code": "QS",
"target": [ {
"code": "QS",
"comment": "exact match",
"display": "Monitored anesthesia care service",
"equivalence": "equivalent"
} ],
"display": "Monitored anesthesia care service"
}, {
"code": "QT",
"target": [ {
"code": "QT",
"comment": "exact match",
"display": "Recording and storage on tape by an analog tape recorder",
"equivalence": "equivalent"
} ],
"display": "Recording and storage on tape by an analog tape recorder"
}, {
"code": "QW",
"target": [ {
"code": "QW",
"comment": "exact match",
"display": "Clia waived test",
"equivalence": "equivalent"
} ],
"display": "Clia waived test"
}, {
"code": "QX",
"target": [ {
"code": "QX",
"comment": "exact match",
"display": "Crna service: with medical direction by a physician",
"equivalence": "equivalent"
} ],
"display": "Crna service: with medical direction by a physician"
}, {
"code": "QY",
"target": [ {
"code": "QY",
"comment": "exact match",
"display": "Medical direction of one certified registered nurse anesthetist (crna) by an anesthesiologist",
"equivalence": "equivalent"
} ],
"display": "Medical direction of one certified registered nurse anesthetist (crna) by an anesthesiologist"
}, {
"code": "QZ",
"target": [ {
"code": "QZ",
"comment": "exact match",
"display": "Crna service: without medical direction by a physician",
"equivalence": "equivalent"
} ],
"display": "Crna service: without medical direction by a physician"
}, {
"code": "RA",
"target": [ {
"code": "RA",
"comment": "exact match",
"display": "Replacement of a dme, orthotic or prosthetic item",
"equivalence": "equivalent"
} ],
"display": "Replacement of a dme, orthotic or prosthetic item"
}, {
"code": "RB",
"target": [ {
"code": "RB",
"comment": "exact match",
"display": "Replacement of a part of a dme, orthotic or prosthetic item furnished as part of a repair",
"equivalence": "equivalent"
} ],
"display": "Replacement of a part of a dme, orthotic or prosthetic item furnished as part of a repair"
}, {
"code": "RC",
"target": [ {
"code": "RC",
"comment": "exact match",
"display": "Right coronary artery",
"equivalence": "equivalent"
} ],
"display": "Right coronary artery"
}, {
"code": "RD",
"target": [ {
"code": "RD",
"comment": "exact match",
"display": "Drug provided to beneficiary, but not administered \"incident-to\"",
"equivalence": "equivalent"
} ],
"display": "Drug provided to beneficiary, but not administered \"incident-to\""
}, {
"code": "RE",
"target": [ {
"code": "RE",
"comment": "exact match",
"display": "Furnished in full compliance with fda-mandated risk evaluation and mitigation strategy (rems)",
"equivalence": "equivalent"
} ],
"display": "Furnished in full compliance with fda-mandated risk evaluation and mitigation strategy (rems)"
}, {
"code": "RI",
"target": [ {
"code": "RI",
"comment": "exact match",
"display": "Ramus intermedius coronary artery",
"equivalence": "equivalent"
} ],
"display": "Ramus intermedius coronary artery"
}, {
"code": "RR",
"target": [ {
"code": "RR",
"comment": "exact match",
"display": "Rental (use the 'rr' modifier when dme is to be rented)",
"equivalence": "equivalent"
} ],
"display": "Rental (use the 'rr' modifier when dme is to be rented)"
}, {
"code": "RT",
"target": [ {
"code": "RT",
"comment": "exact match",
"display": "Right side (used to identify procedures performed on the right side of the body)",
"equivalence": "equivalent"
} ],
"display": "Right side (used to identify procedures performed on the right side of the body)"
}, {
"code": "SA",
"target": [ {
"code": "SA",
"comment": "exact match",
"display": "Nurse practitioner rendering service in collaboration with a physician",
"equivalence": "equivalent"
} ],
"display": "Nurse practitioner rendering service in collaboration with a physician"
}, {
"code": "SB",
"target": [ {
"code": "SB",
"comment": "exact match",
"display": "Nurse midwife",
"equivalence": "equivalent"
} ],
"display": "Nurse midwife"
}, {
"code": "SC",
"target": [ {
"code": "SC",
"comment": "exact match",
"display": "Medically necessary service or supply",
"equivalence": "equivalent"
} ],
"display": "Medically necessary service or supply"
}, {
"code": "SD",
"target": [ {
"code": "SD",
"comment": "exact match",
"display": "Services provided by registered nurse with specialized, highly technical home infusion training",
"equivalence": "equivalent"
} ],
"display": "Services provided by registered nurse with specialized, highly technical home infusion training"
}, {
"code": "SE",
"target": [ {
"code": "SE",
"comment": "exact match",
"display": "State and/or federally-funded programs/services",
"equivalence": "equivalent"
} ],
"display": "State and/or federally-funded programs/services"
}, {
"code": "SF",
"target": [ {
"code": "SF",
"comment": "exact match",
"display": "Second opinion ordered by a professional review organization (pro) per section 9401, p.l. 99-272 (100% reimbursement - no medicare deductible or coinsurance)",
"equivalence": "equivalent"
} ],
"display": "Second opinion ordered by a professional review organization (pro) per section 9401, p.l. 99-272 (100% reimbursement - no medicare deductible or coinsurance)"
}, {
"code": "SG",
"target": [ {
"code": "SG",
"comment": "exact match",
"display": "Ambulatory surgical center (asc) facility service",
"equivalence": "equivalent"
} ],
"display": "Ambulatory surgical center (asc) facility service"
}, {
"code": "SH",
"target": [ {
"code": "SH",
"comment": "exact match",
"display": "Second concurrently administered infusion therapy",
"equivalence": "equivalent"
} ],
"display": "Second concurrently administered infusion therapy"
}, {
"code": "SJ",
"target": [ {
"code": "SJ",
"comment": "exact match",
"display": "Third or more concurrently administered infusion therapy",
"equivalence": "equivalent"
} ],
"display": "Third or more concurrently administered infusion therapy"
}, {
"code": "SK",
"target": [ {
"code": "SK",
"comment": "exact match",
"display": "Member of high risk population (use only with codes for immunization)",
"equivalence": "equivalent"
} ],
"display": "Member of high risk population (use only with codes for immunization)"
}, {
"code": "SL",
"target": [ {
"code": "SL",
"comment": "exact match",
"display": "State supplied vaccine",
"equivalence": "equivalent"
} ],
"display": "State supplied vaccine"
}, {
"code": "SM",
"target": [ {
"code": "SM",
"comment": "exact match",
"display": "Second surgical opinion",
"equivalence": "equivalent"
} ],
"display": "Second surgical opinion"
}, {
"code": "SN",
"target": [ {
"code": "SN",
"comment": "exact match",
"display": "Third surgical opinion",
"equivalence": "equivalent"
} ],
"display": "Third surgical opinion"
}, {
"code": "SQ",
"target": [ {
"code": "SQ",
"comment": "exact match",
"display": "Item ordered by home health",
"equivalence": "equivalent"
} ],
"display": "Item ordered by home health"
}, {
"code": "SS",
"target": [ {
"code": "SS",
"comment": "exact match",
"display": "Home infusion services provided in the infusion suite of the iv therapy provider",
"equivalence": "equivalent"
} ],
"display": "Home infusion services provided in the infusion suite of the iv therapy provider"
}, {
"code": "ST",
"target": [ {
"code": "ST",
"comment": "exact match",
"display": "Related to trauma or injury",
"equivalence": "equivalent"
} ],
"display": "Related to trauma or injury"
}, {
"code": "SU",
"target": [ {
"code": "SU",
"comment": "exact match",
"display": "Procedure performed in physician's office (to denote use of facility and equipment)",
"equivalence": "equivalent"
} ],
"display": "Procedure performed in physician's office (to denote use of facility and equipment)"
}, {
"code": "SV",
"target": [ {
"code": "SV",
"comment": "exact match",
"display": "Pharmaceuticals delivered to patient's home but not utilized",
"equivalence": "equivalent"
} ],
"display": "Pharmaceuticals delivered to patient's home but not utilized"
}, {
"code": "SW",
"target": [ {
"code": "SW",
"comment": "exact match",
"display": "Services provided by a certified diabetic educator",
"equivalence": "equivalent"
} ],
"display": "Services provided by a certified diabetic educator"
}, {
"code": "SY",
"target": [ {
"code": "SY",
"comment": "exact match",
"display": "Persons who are in close contact with member of high-risk population (use only with codes for immunization)",
"equivalence": "equivalent"
} ],
"display": "Persons who are in close contact with member of high-risk population (use only with codes for immunization)"
}, {
"code": "T1",
"target": [ {
"code": "T1",
"comment": "exact match",
"display": "Left foot, second digit",
"equivalence": "equivalent"
} ],
"display": "Left foot, second digit"
}, {
"code": "T2",
"target": [ {
"code": "T2",
"comment": "exact match",
"display": "Left foot, third digit",
"equivalence": "equivalent"
} ],
"display": "Left foot, third digit"
}, {
"code": "T3",
"target": [ {
"code": "T3",
"comment": "exact match",
"display": "Left foot, fourth digit",
"equivalence": "equivalent"
} ],
"display": "Left foot, fourth digit"
}, {
"code": "T4",
"target": [ {
"code": "T4",
"comment": "exact match",
"display": "Left foot, fifth digit",
"equivalence": "equivalent"
} ],
"display": "Left foot, fifth digit"
}, {
"code": "T5",
"target": [ {
"code": "T5",
"comment": "exact match",
"display": "Right foot, great toe",
"equivalence": "equivalent"
} ],
"display": "Right foot, great toe"
}, {
"code": "T6",
"target": [ {
"code": "T6",
"comment": "exact match",
"display": "Right foot, second digit",
"equivalence": "equivalent"
} ],
"display": "Right foot, second digit"
}, {
"code": "T7",
"target": [ {
"code": "T7",
"comment": "exact match",
"display": "Right foot, third digit",
"equivalence": "equivalent"
} ],
"display": "Right foot, third digit"
}, {
"code": "T8",
"target": [ {
"code": "T8",
"comment": "exact match",
"display": "Right foot, fourth digit",
"equivalence": "equivalent"
} ],
"display": "Right foot, fourth digit"
}, {
"code": "T9",
"target": [ {
"code": "T9",
"comment": "exact match",
"display": "Right foot, fifth digit",
"equivalence": "equivalent"
} ],
"display": "Right foot, fifth digit"
}, {
"code": "TA",
"target": [ {
"code": "TA",
"comment": "exact match",
"display": "Left foot, great toe",
"equivalence": "equivalent"
} ],
"display": "Left foot, great toe"
}, {
"code": "TB",
"target": [ {
"code": "TB",
"comment": "exact match",
"display": "Drug or biological acquired with 340b drug pricing program discount, reported for informational purposes",
"equivalence": "equivalent"
} ],
"display": "Drug or biological acquired with 340b drug pricing program discount, reported for informational purposes"
}, {
"code": "TC",
"target": [ {
"code": "TC",
"comment": "exact match",
"display": "Technical component; under certain circumstances, a charge may be made for the technical component alone; under those circumstances the technical component charge is identified by adding modifier 'tc' to the usual procedure number; technical component charges are institutional charges and not billed separately by physicians; however, portable x-ray suppliers only bill for technical component and should utilize modifier tc; the charge data from portable x-ray suppliers will then be used to build customary and prevailing profiles",
"equivalence": "equivalent"
} ],
"display": "Technical component; under certain circumstances, a charge may be made for the technical component alone; under those circumstances the technical component charge is identified by adding modifier 'tc' to the usual procedure number; technical component charges are institutional charges and not billed separately by physicians; however, portable x-ray suppliers only bill for technical component and should utilize modifier tc; the charge data from portable x-ray suppliers will then be used to build customary and prevailing profiles"
}, {
"code": "TD",
"target": [ {
"code": "TD",
"comment": "exact match",
"display": "Rn",
"equivalence": "equivalent"
} ],
"display": "Rn"
}, {
"code": "TE",
"target": [ {
"code": "TE",
"comment": "exact match",
"display": "Lpn/lvn",
"equivalence": "equivalent"
} ],
"display": "Lpn/lvn"
}, {
"code": "TF",
"target": [ {
"code": "TF",
"comment": "exact match",
"display": "Intermediate level of care",
"equivalence": "equivalent"
} ],
"display": "Intermediate level of care"
}, {
"code": "TG",
"target": [ {
"code": "TG",
"comment": "exact match",
"display": "Complex/high tech level of care",
"equivalence": "equivalent"
} ],
"display": "Complex/high tech level of care"
}, {
"code": "TH",
"target": [ {
"code": "TH",
"comment": "exact match",
"display": "Obstetrical treatment/services, prenatal or postpartum",
"equivalence": "equivalent"
} ],
"display": "Obstetrical treatment/services, prenatal or postpartum"
}, {
"code": "TJ",
"target": [ {
"code": "TJ",
"comment": "exact match",
"display": "Program group, child and/or adolescent",
"equivalence": "equivalent"
} ],
"display": "Program group, child and/or adolescent"
}, {
"code": "TK",
"target": [ {
"code": "TK",
"comment": "exact match",
"display": "Extra patient or passenger, non-ambulance",
"equivalence": "equivalent"
} ],
"display": "Extra patient or passenger, non-ambulance"
}, {
"code": "TL",
"target": [ {
"code": "TL",
"comment": "exact match",
"display": "Early intervention/individualized family service plan (ifsp)",
"equivalence": "equivalent"
} ],
"display": "Early intervention/individualized family service plan (ifsp)"
}, {
"code": "TM",
"target": [ {
"code": "TM",
"comment": "exact match",
"display": "Individualized education program (iep)",
"equivalence": "equivalent"
} ],
"display": "Individualized education program (iep)"
}, {
"code": "TN",
"target": [ {
"code": "TN",
"comment": "exact match",
"display": "Rural/outside providers' customary service area",
"equivalence": "equivalent"
} ],
"display": "Rural/outside providers' customary service area"
}, {
"code": "TP",
"target": [ {
"code": "TP",
"comment": "exact match",
"display": "Medical transport, unloaded vehicle",
"equivalence": "equivalent"
} ],
"display": "Medical transport, unloaded vehicle"
}, {
"code": "TQ",
"target": [ {
"code": "TQ",
"comment": "exact match",
"display": "Basic life support transport by a volunteer ambulance provider",
"equivalence": "equivalent"
} ],
"display": "Basic life support transport by a volunteer ambulance provider"
}, {
"code": "TR",
"target": [ {
"code": "TR",
"comment": "exact match",
"display": "School-based individualized education program (iep) services provided outside the public school district responsible for the student",
"equivalence": "equivalent"
} ],
"display": "School-based individualized education program (iep) services provided outside the public school district responsible for the student"
}, {
"code": "TS",
"target": [ {
"code": "TS",
"comment": "exact match",
"display": "Follow-up service",
"equivalence": "equivalent"
} ],
"display": "Follow-up service"
}, {
"code": "TT",
"target": [ {
"code": "TT",
"comment": "exact match",
"display": "Individualized service provided to more than one patient in same setting",
"equivalence": "equivalent"
} ],
"display": "Individualized service provided to more than one patient in same setting"
}, {
"code": "TU",
"target": [ {
"code": "TU",
"comment": "exact match",
"display": "Special payment rate, overtime",
"equivalence": "equivalent"
} ],
"display": "Special payment rate, overtime"
}, {
"code": "TV",
"target": [ {
"code": "TV",
"comment": "exact match",
"display": "Special payment rates, holidays/weekends",
"equivalence": "equivalent"
} ],
"display": "Special payment rates, holidays/weekends"
}, {
"code": "TW",
"target": [ {
"code": "TW",
"comment": "exact match",
"display": "Back-up equipment",
"equivalence": "equivalent"
} ],
"display": "Back-up equipment"
}, {
"code": "U1",
"target": [ {
"code": "U1",
"comment": "exact match",
"display": "Medicaid level of care 1, as defined by each state",
"equivalence": "equivalent"
} ],
"display": "Medicaid level of care 1, as defined by each state"
}, {
"code": "U2",
"target": [ {
"code": "U2",
"comment": "exact match",
"display": "Medicaid level of care 2, as defined by each state",
"equivalence": "equivalent"
} ],
"display": "Medicaid level of care 2, as defined by each state"
}, {
"code": "U3",
"target": [ {
"code": "U3",
"comment": "exact match",
"display": "Medicaid level of care 3, as defined by each state",
"equivalence": "equivalent"
} ],
"display": "Medicaid level of care 3, as defined by each state"
}, {
"code": "U4",
"target": [ {
"code": "U4",
"comment": "exact match",
"display": "Medicaid level of care 4, as defined by each state",
"equivalence": "equivalent"
} ],
"display": "Medicaid level of care 4, as defined by each state"
}, {
"code": "U5",
"target": [ {
"code": "U5",
"comment": "exact match",
"display": "Medicaid level of care 5, as defined by each state",
"equivalence": "equivalent"
} ],
"display": "Medicaid level of care 5, as defined by each state"
}, {
"code": "U6",
"target": [ {
"code": "U6",
"comment": "exact match",
"display": "Medicaid level of care 6, as defined by each state",
"equivalence": "equivalent"
} ],
"display": "Medicaid level of care 6, as defined by each state"
}, {
"code": "U7",
"target": [ {
"code": "U7",
"comment": "exact match",
"display": "Medicaid level of care 7, as defined by each state",
"equivalence": "equivalent"
} ],
"display": "Medicaid level of care 7, as defined by each state"
}, {
"code": "U8",
"target": [ {
"code": "U8",
"comment": "exact match",
"display": "Medicaid level of care 8, as defined by each state",
"equivalence": "equivalent"
} ],
"display": "Medicaid level of care 8, as defined by each state"
}, {
"code": "U9",
"target": [ {
"code": "U9",
"comment": "exact match",
"display": "Medicaid level of care 9, as defined by each state",
"equivalence": "equivalent"
} ],
"display": "Medicaid level of care 9, as defined by each state"
}, {
"code": "UA",
"target": [ {
"code": "UA",
"comment": "exact match",
"display": "Medicaid level of care 10, as defined by each state",
"equivalence": "equivalent"
} ],
"display": "Medicaid level of care 10, as defined by each state"
}, {
"code": "UB",
"target": [ {
"code": "UB",
"comment": "exact match",
"display": "Medicaid level of care 11, as defined by each state",
"equivalence": "equivalent"
} ],
"display": "Medicaid level of care 11, as defined by each state"
}, {
"code": "UC",
"target": [ {
"code": "UC",
"comment": "exact match",
"display": "Medicaid level of care 12, as defined by each state",
"equivalence": "equivalent"
} ],
"display": "Medicaid level of care 12, as defined by each state"
}, {
"code": "UD",
"target": [ {
"code": "UD",
"comment": "exact match",
"display": "Medicaid level of care 13, as defined by each state",
"equivalence": "equivalent"
} ],
"display": "Medicaid level of care 13, as defined by each state"
}, {
"code": "UE",
"target": [ {
"code": "UE",
"comment": "exact match",
"display": "Used durable medical equipment",
"equivalence": "equivalent"
} ],
"display": "Used durable medical equipment"
}, {
"code": "UF",
"target": [ {
"code": "UF",
"comment": "exact match",
"display": "Services provided in the morning",
"equivalence": "equivalent"
} ],
"display": "Services provided in the morning"
}, {
"code": "UG",
"target": [ {
"code": "UG",
"comment": "exact match",
"display": "Services provided in the afternoon",
"equivalence": "equivalent"
} ],
"display": "Services provided in the afternoon"
}, {
"code": "UH",
"target": [ {
"code": "UH",
"comment": "exact match",
"display": "Services provided in the evening",
"equivalence": "equivalent"
} ],
"display": "Services provided in the evening"
}, {
"code": "UJ",
"target": [ {
"code": "UJ",
"comment": "exact match",
"display": "Services provided at night",
"equivalence": "equivalent"
} ],
"display": "Services provided at night"
}, {
"code": "UK",
"target": [ {
"code": "UK",
"comment": "exact match",
"display": "Services provided on behalf of the client to someone other than the client (collateral relationship)",
"equivalence": "equivalent"
} ],
"display": "Services provided on behalf of the client to someone other than the client (collateral relationship)"
}, {
"code": "UN",
"target": [ {
"code": "UN",
"comment": "exact match",
"display": "Two patients served",
"equivalence": "equivalent"
} ],
"display": "Two patients served"
}, {
"code": "UP",
"target": [ {
"code": "UP",
"comment": "exact match",
"display": "Three patients served",
"equivalence": "equivalent"
} ],
"display": "Three patients served"
}, {
"code": "UQ",
"target": [ {
"code": "UQ",
"comment": "exact match",
"display": "Four patients served",
"equivalence": "equivalent"
} ],
"display": "Four patients served"
}, {
"code": "UR",
"target": [ {
"code": "UR",
"comment": "exact match",
"display": "Five patients served",
"equivalence": "equivalent"
} ],
"display": "Five patients served"
}, {
"code": "US",
"target": [ {
"code": "US",
"comment": "exact match",
"display": "Six or more patients served",
"equivalence": "equivalent"
} ],
"display": "Six or more patients served"
}, {
"code": "V1",
"target": [ {
"code": "V1",
"comment": "exact match",
"display": "Demonstration modifier 1",
"equivalence": "equivalent"
} ],
"display": "Demonstration modifier 1"
}, {
"code": "V2",
"target": [ {
"code": "V2",
"comment": "exact match",
"display": "Demonstration modifier 2",
"equivalence": "equivalent"
} ],
"display": "Demonstration modifier 2"
}, {
"code": "V3",
"target": [ {
"code": "V3",
"comment": "exact match",
"display": "Demonstration modifier 3",
"equivalence": "equivalent"
} ],
"display": "Demonstration modifier 3"
}, {
"code": "V4",
"target": [ {
"code": "1021910",
"comment": "exact match",
"display": "Level II (HCPCS/National) Modifiers",
"equivalence": "equivalent"
} ],
"display": "Demonstration modifier 4"
}, {
"code": "V5",
"target": [ {
"code": "V5",
"comment": "exact match",
"display": "Vascular catheter (alone or with any other vascular access)",
"equivalence": "equivalent"
} ],
"display": "Vascular catheter (alone or with any other vascular access)"
}, {
"code": "V6",
"target": [ {
"code": "V6",
"comment": "exact match",
"display": "Arteriovenous graft (or other vascular access not including a vascular catheter)",
"equivalence": "equivalent"
} ],
"display": "Arteriovenous graft (or other vascular access not including a vascular catheter)"
}, {
"code": "V7",
"target": [ {
"code": "V7",
"comment": "exact match",
"display": "Arteriovenous fistula only (in use with two needles)",
"equivalence": "equivalent"
} ],
"display": "Arteriovenous fistula only (in use with two needles)"
}, {
"code": "VM",
"target": [ {
"code": "VM",
"comment": "exact match",
"display": "Medicare diabetes prevention program (mdpp) virtual make-up session",
"equivalence": "equivalent"
} ],
"display": "Medicare diabetes prevention program (mdpp) virtual make-up session"
}, {
"code": "VP",
"target": [ {
"code": "VP",
"comment": "exact match",
"display": "Aphakic patient",
"equivalence": "equivalent"
} ],
"display": "Aphakic patient"
}, {
"code": "X1",
"target": [ {
"code": "X1",
"comment": "exact match",
"display": "Continuous/broad services: for reporting services by clinicians, who provide the principal care for a patient, with no planned endpoint of the relationship; services in this category represent comprehensive care, dealing with the entire scope of patient problems, either directly or in a care coordination role; reporting clinician service examples include, but are not limited to: primary care, and clinicians providing comprehensive care to patients in addition to specialty care",
"equivalence": "equivalent"
} ],
"display": "Continuous/broad services: for reporting services by clinicians, who provide the principal care for a patient, with no planned endpoint of the relationship; services in this category represent comprehensive care, dealing with the entire scope of patient problems, either directly or in a care coordination role; reporting clinician service examples include, but are not limited to: primary care, and clinicians providing comprehensive care to patients in addition to specialty care"
}, {
"code": "X2",
"target": [ {
"code": "X2",
"comment": "exact match",
"display": "Continuous/focused services: for reporting services by clinicians whose expertise is needed for the ongoing management of a chronic disease or a condition that needs to be managed and followed with no planned endpoint to the relationship; reporting clinician service examples include but are not limited to: a rheumatologist taking care of the patient's rheumatoid arthritis longitudinally but not providing general primary care services",
"equivalence": "equivalent"
} ],
"display": "Continuous/focused services: for reporting services by clinicians whose expertise is needed for the ongoing management of a chronic disease or a condition that needs to be managed and followed with no planned endpoint to the relationship; reporting clinician service examples include but are not limited to: a rheumatologist taking care of the patient's rheumatoid arthritis longitudinally but not providing general primary care services"
}, {
"code": "X3",
"target": [ {
"code": "X3",
"comment": "exact match",
"display": "Episodic/broad servies: for reporting services by clinicians who have broad responsibility for the comprehensive needs of the patient that is limited to a defined period and circumstance such as a hospitalization; reporting clinician service examples include but are not limited to the hospitalist's services rendered providing comprehensive and general care to a patient while admitted to the hospital",
"equivalence": "equivalent"
} ],
"display": "Episodic/broad servies: for reporting services by clinicians who have broad responsibility for the comprehensive needs of the patient that is limited to a defined period and circumstance such as a hospitalization; reporting clinician service examples include but are not limited to the hospitalist's services rendered providing comprehensive and general care to a patient while admitted to the hospital"
}, {
"code": "X4",
"target": [ {
"code": "X4",
"comment": "exact match",
"display": "Episodic/focused services: for reporting services by clinicians who provide focused care on particular types of treatment limited to a defined period and circumstance; the patient has a problem, acute or chronic, that will be treated with surgery, radiation, or some other type of generally time-limited intervention; reporting clinician service examples include but are not limited to, the orthopedic surgeon performing a knee replacement and seeing the patient through the postoperative period",
"equivalence": "equivalent"
} ],
"display": "Episodic/focused services: for reporting services by clinicians who provide focused care on particular types of treatment limited to a defined period and circumstance; the patient has a problem, acute or chronic, that will be treated with surgery, radiation, or some other type of generally time-limited intervention; reporting clinician service examples include but are not limited to, the orthopedic surgeon performing a knee replacement and seeing the patient through the postoperative period"
}, {
"code": "X5",
"target": [ {
"code": "X5",
"comment": "exact match",
"display": "Diagnostic services requested by another clinician: for reporting services by a clinician who furnishes care to the patient only as requested by another clinician or subsequent and related services requested by another clinician; this modifier is reported for patient relationships that may not be adequately captured by the above alternative categories; reporting clinician service examples include but are not limited to, the radiologist's interpretation of an imaging study requested by another clinician",
"equivalence": "equivalent"
} ],
"display": "Diagnostic services requested by another clinician: for reporting services by a clinician who furnishes care to the patient only as requested by another clinician or subsequent and related services requested by another clinician; this modifier is reported for patient relationships that may not be adequately captured by the above alternative categories; reporting clinician service examples include but are not limited to, the radiologist's interpretation of an imaging study requested by another clinician"
}, {
"code": "XE",
"target": [ {
"code": "XE",
"comment": "exact match",
"display": "Separate encounter, a service that is distinct because it occurred during a separate encounter",
"equivalence": "equivalent"
} ],
"display": "Separate encounter, a service that is distinct because it occurred during a separate encounter"
}, {
"code": "XP",
"target": [ {
"code": "XP",
"comment": "exact match",
"display": "Separate practitioner, a service that is distinct because it was performed by a different practitioner",
"equivalence": "equivalent"
} ],
"display": "Separate practitioner, a service that is distinct because it was performed by a different practitioner"
}, {
"code": "XS",
"target": [ {
"code": "XS",
"comment": "exact match",
"display": "Separate structure, a service that is distinct because it was performed on a separate organ/structure",
"equivalence": "equivalent"
} ],
"display": "Separate structure, a service that is distinct because it was performed on a separate organ/structure"
}, {
"code": "XU",
"target": [ {
"code": "XU",
"comment": "exact match",
"display": "Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service",
"equivalence": "equivalent"
} ],
"display": "Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service"
}, {
"code": "Level 3: D7340-D7350",
"target": [ {
"code": "1007011",
"comment": "exact match",
"display": "Vestibuloplasty",
"equivalence": "equivalent"
} ],
"display": "Vestibuloplasty"
}, {
"code": "Level 2: G0008-G0010",
"target": [ {
"code": "90472",
"comment": "exact match",
"display": "Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections); each additional vaccine (single or combination vaccine/toxoid) (List separately in addition to code for primary procedure)",
"equivalence": "equivalent"
} ],
"display": "Vaccine Administration"
}, {
"code": "G0008",
"target": [ {
"code": "90472",
"comment": "exact match",
"display": "Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections); each additional vaccine (single or combination vaccine/toxoid) (List separately in addition to code for primary procedure)",
"equivalence": "equivalent"
} ],
"display": "Administration of influenza virus vaccine"
}, {
"code": "G0009",
"target": [ {
"code": "90472",
"comment": "exact match",
"display": "Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections); each additional vaccine (single or combination vaccine/toxoid) (List separately in addition to code for primary procedure)",
"equivalence": "equivalent"
} ],
"display": "Administration of pneumococcal vaccine"
}, {
"code": "G0010",
"target": [ {
"code": "90472",
"comment": "exact match",
"display": "Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections); each additional vaccine (single or combination vaccine/toxoid) (List separately in addition to code for primary procedure)",
"equivalence": "equivalent"
} ],
"display": "Administration of hepatitis b vaccine"
}, {
"code": "Level 2: G0027-G0027",
"target": [ {
"code": "1012549",
"comment": "exact match",
"display": "Semen analysis",
"equivalence": "equivalent"
} ],
"display": "Semen Analysis"
}, {
"code": "G0027",
"target": [ {
"code": "1012549",
"comment": "exact match",
"display": "Semen analysis",
"equivalence": "equivalent"
} ],
"display": "Semen analysis; presence and/or motility of sperm excluding huhner"
}, {
"code": "Level 2: G0491-G0492",
"target": [ {
"code": "1012740",
"comment": "exact match",
"display": "Dialysis Services and Procedures",
"equivalence": "equivalent"
} ],
"display": "Dialysis Procedure"
}, {
"code": "G0491",
"target": [ {
"code": "1012740",
"comment": "exact match",
"display": "Dialysis Services and Procedures",
"equivalence": "equivalent"
} ],
"display": "Dialysis procedure at a medicare certified esrd facility for acute kidney injury without esrd"
}, {
"code": "G0492",
"target": [ {
"code": "1012740",
"comment": "exact match",
"display": "Dialysis Services and Procedures",
"equivalence": "equivalent"
} ],
"display": "Dialysis procedure with single evaluation by a physician or other qualified health care professional for acute kidney injury without esrd"
}, {
"code": "Level 2: G0498-G0498",
"target": [ {
"code": "1013442",
"comment": "exact match",
"display": "Chemotherapy administration",
"equivalence": "equivalent"
} ],
"display": "Chemotherapy Administration"
}, {
"code": "G0498",
"target": [ {
"code": "1013442",
"comment": "exact match",
"display": "Chemotherapy administration",
"equivalence": "equivalent"
} ],
"display": "Chemotherapy administration, intravenous infusion technique; initiation of infusion in the office/clinic setting using office/clinic pump/supplies, with continuation of the infusion in the community setting (e.g., home, domiciliary, rest home or assisted living) using a portable pump provided by the office/clinic, includes follow up office/clinic visit at the conclusion of the infusion"
}, {
"code": "Level 2: G6003-G6017",
"target": [ {
"code": "1010843",
"comment": "exact match",
"display": "Radiation Oncology Treatment",
"equivalence": "equivalent"
} ],
"display": "Radiation Treatment"
}, {
"code": "G6003",
"target": [ {
"code": "1010843",
"comment": "exact match",
"display": "Radiation Oncology Treatment",
"equivalence": "equivalent"
} ],
"display": "Radiation treatment delivery, single treatment area,single port or parallel opposed ports, simple blocks or no blocks: up to 5 mev"
}, {
"code": "G6004",
"target": [ {
"code": "1010843",
"comment": "exact match",
"display": "Radiation Oncology Treatment",
"equivalence": "equivalent"
} ],
"display": "Radiation treatment delivery, single treatment area,single port or parallel opposed ports, simple blocks or no blocks: 6-10 mev"
}, {
"code": "G6005",
"target": [ {
"code": "1010843",
"comment": "exact match",
"display": "Radiation Oncology Treatment",
"equivalence": "equivalent"
} ],
"display": "Radiation treatment delivery, single treatment area,single port or parallel opposed ports, simple blocks or no blocks: 11-19 mev"
}, {
"code": "G6006",
"target": [ {
"code": "1010843",
"comment": "exact match",
"display": "Radiation Oncology Treatment",
"equivalence": "equivalent"
} ],
"display": "Radiation treatment delivery, single treatment area,single port or parallel opposed ports, simple blocks or no blocks: 20 mev or greater"
}, {
"code": "G6007",
"target": [ {
"code": "1010843",
"comment": "exact match",
"display": "Radiation Oncology Treatment",
"equivalence": "equivalent"
} ],
"display": "Radiation treatment delivery, 2 separate treatment areas, 3 or more ports on a single treatment area, use of multiple blocks: up to 5 mev"
}, {
"code": "G6008",
"target": [ {
"code": "1010843",
"comment": "exact match",
"display": "Radiation Oncology Treatment",
"equivalence": "equivalent"
} ],
"display": "Radiation treatment delivery, 2 separate treatment areas, 3 or more ports on a single treatment area, use of multiple blocks: 6-10 mev"
}, {
"code": "G6009",
"target": [ {
"code": "1010843",
"comment": "exact match",
"display": "Radiation Oncology Treatment",
"equivalence": "equivalent"
} ],
"display": "Radiation treatment delivery, 2 separate treatment areas, 3 or more ports on a single treatment area, use of multiple blocks: 11-19 mev"
}, {
"code": "G6010",
"target": [ {
"code": "1010843",
"comment": "exact match",
"display": "Radiation Oncology Treatment",
"equivalence": "equivalent"
} ],
"display": "Radiation treatment delivery, 2 separate treatment areas, 3 or more ports on a single treatment area, use of multiple blocks: 20 mev or greater"
}, {
"code": "G6011",
"target": [ {
"code": "1010843",
"comment": "exact match",
"display": "Radiation Oncology Treatment",
"equivalence": "equivalent"
} ],
"display": "Radiation treatment delivery,3 or more separate treatment areas, custom blocking, tangential ports, wedges, rotational beam, compensators, electron beam; up to 5 mev"
}, {
"code": "G6012",
"target": [ {
"code": "1010843",
"comment": "exact match",
"display": "Radiation Oncology Treatment",
"equivalence": "equivalent"
} ],
"display": "Radiation treatment delivery,3 or more separate treatment areas, custom blocking, tangential ports, wedges, rotational beam, compensators, electron beam; 6-10 mev"
}, {
"code": "G6013",
"target": [ {
"code": "1010843",
"comment": "exact match",
"display": "Radiation Oncology Treatment",
"equivalence": "equivalent"
} ],
"display": "Radiation treatment delivery,3 or more separate treatment areas, custom blocking, tangential ports, wedges, rotational beam, compensators, electron beam; 11-19 mev"
}, {
"code": "G6014",
"target": [ {
"code": "1010843",
"comment": "exact match",
"display": "Radiation Oncology Treatment",
"equivalence": "equivalent"
} ],
"display": "Radiation treatment delivery,3 or more separate treatment areas, custom blocking, tangential ports, wedges, rotational beam, compensators, electron beam; 20 mev or greater"
}, {
"code": "G6015",
"target": [ {
"code": "1010843",
"comment": "exact match",
"display": "Radiation Oncology Treatment",
"equivalence": "equivalent"
} ],
"display": "Intensity modulated treatment delivery, single or multiple fields/arcs,via narrow spatially and temporally modulated beams, binary, dynamic mlc, per treatment session"
}, {
"code": "G6016",
"target": [ {
"code": "1010843",
"comment": "exact match",
"display": "Radiation Oncology Treatment",
"equivalence": "equivalent"
} ],
"display": "Compensator-based beam modulation treatment delivery of inverse planned treatment using 3 or more high resolution (milled or cast) compensator, convergent beam modulated fields, per treatment session"
}, {
"code": "G6017",
"target": [ {
"code": "1010843",
"comment": "exact match",
"display": "Radiation Oncology Treatment",
"equivalence": "equivalent"
} ],
"display": "Intra-fraction localization and tracking of target or patient motion during delivery of radiation therapy (eg,3d positional tracking, gating, 3d surface tracking), each fraction of treatment"
}, {
"code": "G9654",
"target": [ {
"code": "QS",
"comment": "exact match",
"display": "Monitored anesthesia care service",
"equivalence": "equivalent"
} ],
"display": "Monitored anesthesia care (mac)"
}, {
"code": "L8039",
"target": [ {
"code": "19325",
"comment": "exact match",
"display": "Breast augmentation with implant",
"equivalence": "equivalent"
} ],
"display": "Breast prosthesis, not otherwise specified"
}, {
"code": "M1069",
"target": [ {
"code": "1019374",
"comment": "exact match",
"display": "Patient screened for future fall risk",
"equivalence": "equivalent"
} ],
"display": "Patient screened for future fall risk"
}, {
"code": "Level 1: P0000-P9999",
"target": [ {
"code": "1014993",
"comment": "exact match",
"display": "Services in Pathology and Laboratory",
"equivalence": "equivalent"
} ],
"display": "Pathology and Laboratory Services"
}, {
"code": "Level 2: P2028-P2038",
"target": [ {
"code": "1014993",
"comment": "exact match",
"display": "Services in Pathology and Laboratory",
"equivalence": "equivalent"
} ],
"display": "Chemistry and Toxicology Tests"
}, {
"code": "P2028",
"target": [ {
"code": "1014993",
"comment": "exact match",
"display": "Services in Pathology and Laboratory",
"equivalence": "equivalent"
} ],
"display": "Cephalin floculation, blood"
}, {
"code": "P2029",
"target": [ {
"code": "1014993",
"comment": "exact match",
"display": "Services in Pathology and Laboratory",
"equivalence": "equivalent"
} ],
"display": "Congo red, blood"
}, {
"code": "P2031",
"target": [ {
"code": "1014993",
"comment": "exact match",
"display": "Services in Pathology and Laboratory",
"equivalence": "equivalent"
} ],
"display": "Hair analysis (excluding arsenic)"
}, {
"code": "P2033",
"target": [ {
"code": "1014993",
"comment": "exact match",
"display": "Services in Pathology and Laboratory",
"equivalence": "equivalent"
} ],
"display": "Thymol turbidity, blood"
}, {
"code": "P2038",
"target": [ {
"code": "1014993",
"comment": "exact match",
"display": "Services in Pathology and Laboratory",
"equivalence": "equivalent"
} ],
"display": "Mucoprotein, blood (seromucoid) (medical necessity procedure)"
}, {
"code": "Level 2: P3000-P3001",
"target": [ {
"code": "1014993",
"comment": "exact match",
"display": "Services in Pathology and Laboratory",
"equivalence": "equivalent"
} ],
"display": "Pathology Screening Tests"
}, {
"code": "P3000",
"target": [ {
"code": "1014993",
"comment": "exact match",
"display": "Services in Pathology and Laboratory",
"equivalence": "equivalent"
} ],
"display": "Screening papanicolaou smear, cervical or vaginal, up to three smears, by technician under physician supervision"
}, {
"code": "P3001",
"target": [ {
"code": "1014993",
"comment": "exact match",
"display": "Services in Pathology and Laboratory",
"equivalence": "equivalent"
} ],
"display": "Screening papanicolaou smear, cervical or vaginal, up to three smears, requiring interpretation by physician"
}, {
"code": "Level 2: P7001-P7001",
"target": [ {
"code": "87999",
"comment": "exact match",
"display": "Unlisted microbiology procedure",
"equivalence": "equivalent"
} ],
"display": "Microbiology Tests"
}, {
"code": "Level 2: P7001-P7001",
"target": [ {
"code": "1012134",
"comment": "exact match",
"display": "Microbiology Procedures",
"equivalence": "equivalent"
} ],
"display": "Microbiology Tests"
}, {
"code": "P7001",
"target": [ {
"code": "87999",
"comment": "exact match",
"display": "Unlisted microbiology procedure",
"equivalence": "equivalent"
} ],
"display": "Culture, bacterial, urine; quantitative, sensitivity study"
}, {
"code": "P7001",
"target": [ {
"code": "1012134",
"comment": "exact match",
"display": "Microbiology Procedures",
"equivalence": "equivalent"
} ],
"display": "Culture, bacterial, urine; quantitative, sensitivity study"
}, {
"code": "Level 2: P9010-P9100",
"target": [ {
"code": "1014993",
"comment": "exact match",
"display": "Services in Pathology and Laboratory",
"equivalence": "equivalent"
} ],
"display": "Miscellaneous Pathology and Laboratory Services"
}, {
"code": "P9010",
"target": [ {
"code": "1014993",
"comment": "exact match",
"display": "Services in Pathology and Laboratory",
"equivalence": "equivalent"
} ],
"display": "Blood (whole), for transfusion, per unit"
}, {
"code": "P9011",
"target": [ {
"code": "1014993",
"comment": "exact match",
"display": "Services in Pathology and Laboratory",
"equivalence": "equivalent"
} ],
"display": "Blood, split unit"
}, {
"code": "P9012",
"target": [ {
"code": "1014993",
"comment": "exact match",
"display": "Services in Pathology and Laboratory",
"equivalence": "equivalent"
} ],
"display": "Cryoprecipitate, each unit"
}, {
"code": "P9016",
"target": [ {
"code": "1014993",
"comment": "exact match",
"display": "Services in Pathology and Laboratory",
"equivalence": "equivalent"
} ],
"display": "Red blood cells, leukocytes reduced, each unit"
}, {
"code": "P9017",
"target": [ {
"code": "1014993",
"comment": "exact match",
"display": "Services in Pathology and Laboratory",
"equivalence": "equivalent"
} ],
"display": "Fresh frozen plasma (single donor), frozen within 8 hours of collection, each unit"
}, {
"code": "P9019",
"target": [ {
"code": "1014993",
"comment": "exact match",
"display": "Services in Pathology and Laboratory",
"equivalence": "equivalent"
} ],
"display": "Platelets, each unit"
}, {
"code": "P9020",
"target": [ {
"code": "1014993",
"comment": "exact match",
"display": "Services in Pathology and Laboratory",
"equivalence": "equivalent"
} ],
"display": "Platelet rich plasma, each unit"
}, {
"code": "P9021",
"target": [ {
"code": "1014993",
"comment": "exact match",
"display": "Services in Pathology and Laboratory",
"equivalence": "equivalent"
} ],
"display": "Red blood cells, each unit"
}, {
"code": "P9022",
"target": [ {
"code": "1014993",
"comment": "exact match",
"display": "Services in Pathology and Laboratory",
"equivalence": "equivalent"
} ],
"display": "Red blood cells, washed, each unit"
}, {
"code": "P9023",
"target": [ {
"code": "1014993",
"comment": "exact match",
"display": "Services in Pathology and Laboratory",
"equivalence": "equivalent"
} ],
"display": "Plasma, pooled multiple donor, solvent/detergent treated, frozen, each unit"
}, {
"code": "P9031",
"target": [ {
"code": "1014993",
"comment": "exact match",
"display": "Services in Pathology and Laboratory",
"equivalence": "equivalent"
} ],
"display": "Platelets, leukocytes reduced, each unit"
}, {
"code": "P9032",
"target": [ {
"code": "1014993",
"comment": "exact match",
"display": "Services in Pathology and Laboratory",
"equivalence": "equivalent"
} ],
"display": "Platelets, irradiated, each unit"
}, {
"code": "P9033",
"target": [ {
"code": "1014993",
"comment": "exact match",
"display": "Services in Pathology and Laboratory",
"equivalence": "equivalent"
} ],
"display": "Platelets, leukocytes reduced, irradiated, each unit"
}, {
"code": "P9034",
"target": [ {
"code": "1014993",
"comment": "exact match",
"display": "Services in Pathology and Laboratory",
"equivalence": "equivalent"
} ],
"display": "Platelets, pheresis, each unit"
}, {
"code": "P9035",
"target": [ {
"code": "1014993",
"comment": "exact match",
"display": "Services in Pathology and Laboratory",
"equivalence": "equivalent"
} ],
"display": "Platelets, pheresis, leukocytes reduced, each unit"
}, {
"code": "P9036",
"target": [ {
"code": "1014993",
"comment": "exact match",
"display": "Services in Pathology and Laboratory",
"equivalence": "equivalent"
} ],
"display": "Platelets, pheresis, irradiated, each unit"
}, {
"code": "P9037",
"target": [ {
"code": "1014993",
"comment": "exact match",
"display": "Services in Pathology and Laboratory",
"equivalence": "equivalent"
} ],
"display": "Platelets, pheresis, leukocytes reduced, irradiated, each unit"
}, {
"code": "P9038",
"target": [ {
"code": "1014993",
"comment": "exact match",
"display": "Services in Pathology and Laboratory",
"equivalence": "equivalent"
} ],
"display": "Red blood cells, irradiated, each unit"
}, {
"code": "P9039",
"target": [ {
"code": "1014993",
"comment": "exact match",
"display": "Services in Pathology and Laboratory",
"equivalence": "equivalent"
} ],
"display": "Red blood cells, deglycerolized, each unit"
}, {
"code": "P9040",
"target": [ {
"code": "1014993",
"comment": "exact match",
"display": "Services in Pathology and Laboratory",
"equivalence": "equivalent"
} ],
"display": "Red blood cells, leukocytes reduced, irradiated, each unit"
}, {
"code": "P9041",
"target": [ {
"code": "1014993",
"comment": "exact match",
"display": "Services in Pathology and Laboratory",
"equivalence": "equivalent"
} ],
"display": "Infusion, albumin (human), 5%, 50 ml"
}, {
"code": "P9043",
"target": [ {
"code": "1014993",
"comment": "exact match",
"display": "Services in Pathology and Laboratory",
"equivalence": "equivalent"
} ],
"display": "Infusion, plasma protein fraction (human), 5%, 50 ml"
}, {
"code": "P9044",
"target": [ {
"code": "1014993",
"comment": "exact match",
"display": "Services in Pathology and Laboratory",
"equivalence": "equivalent"
} ],
"display": "Plasma, cryoprecipitate reduced, each unit"
}, {
"code": "P9045",
"target": [ {
"code": "1014993",
"comment": "exact match",
"display": "Services in Pathology and Laboratory",
"equivalence": "equivalent"
} ],
"display": "Infusion, albumin (human), 5%, 250 ml"
}, {
"code": "P9046",
"target": [ {
"code": "1014993",
"comment": "exact match",
"display": "Services in Pathology and Laboratory",
"equivalence": "equivalent"
} ],
"display": "Infusion, albumin (human), 25%, 20 ml"
}, {
"code": "P9047",
"target": [ {
"code": "1014993",
"comment": "exact match",
"display": "Services in Pathology and Laboratory",
"equivalence": "equivalent"
} ],
"display": "Infusion, albumin (human), 25%, 50 ml"
}, {
"code": "P9048",
"target": [ {
"code": "1014993",
"comment": "exact match",
"display": "Services in Pathology and Laboratory",
"equivalence": "equivalent"
} ],
"display": "Infusion, plasma protein fraction (human), 5%, 250 ml"
}, {
"code": "P9050",
"target": [ {
"code": "1014993",
"comment": "exact match",
"display": "Services in Pathology and Laboratory",
"equivalence": "equivalent"
} ],
"display": "Granulocytes, pheresis, each unit"
}, {
"code": "P9051",
"target": [ {
"code": "1014993",
"comment": "exact match",
"display": "Services in Pathology and Laboratory",
"equivalence": "equivalent"
} ],
"display": "Whole blood or red blood cells, leukocytes reduced, cmv-negative, each unit"
}, {
"code": "P9052",
"target": [ {
"code": "1014993",
"comment": "exact match",
"display": "Services in Pathology and Laboratory",
"equivalence": "equivalent"
} ],
"display": "Platelets, hla-matched leukocytes reduced, apheresis/pheresis, each unit"
}, {
"code": "P9053",
"target": [ {
"code": "1014993",
"comment": "exact match",
"display": "Services in Pathology and Laboratory",
"equivalence": "equivalent"
} ],
"display": "Platelets, pheresis, leukocytes reduced, cmv-negative, irradiated, each unit"
}, {
"code": "P9054",
"target": [ {
"code": "1014993",
"comment": "exact match",
"display": "Services in Pathology and Laboratory",
"equivalence": "equivalent"
} ],
"display": "Whole blood or red blood cells, leukocytes reduced, frozen, deglycerol, washed, each unit"
}, {
"code": "P9055",
"target": [ {
"code": "1014993",
"comment": "exact match",
"display": "Services in Pathology and Laboratory",
"equivalence": "equivalent"
} ],
"display": "Platelets, leukocytes reduced, cmv-negative, apheresis/pheresis, each unit"
}, {
"code": "P9056",
"target": [ {
"code": "1014993",
"comment": "exact match",
"display": "Services in Pathology and Laboratory",
"equivalence": "equivalent"
} ],
"display": "Whole blood, leukocytes reduced, irradiated, each unit"
}, {
"code": "P9057",
"target": [ {
"code": "1014993",
"comment": "exact match",
"display": "Services in Pathology and Laboratory",
"equivalence": "equivalent"
} ],
"display": "Red blood cells, frozen/deglycerolized/washed, leukocytes reduced, irradiated, each unit"
}, {
"code": "P9058",
"target": [ {
"code": "1014993",
"comment": "exact match",
"display": "Services in Pathology and Laboratory",
"equivalence": "equivalent"
} ],
"display": "Red blood cells, leukocytes reduced, cmv-negative, irradiated, each unit"
}, {
"code": "P9059",
"target": [ {
"code": "1014993",
"comment": "exact match",
"display": "Services in Pathology and Laboratory",
"equivalence": "equivalent"
} ],
"display": "Fresh frozen plasma between 8-24 hours of collection, each unit"
}, {
"code": "P9060",
"target": [ {
"code": "1014993",
"comment": "exact match",
"display": "Services in Pathology and Laboratory",
"equivalence": "equivalent"
} ],
"display": "Fresh frozen plasma, donor retested, each unit"
}, {
"code": "P9070",
"target": [ {
"code": "1014993",
"comment": "exact match",
"display": "Services in Pathology and Laboratory",
"equivalence": "equivalent"
} ],
"display": "Plasma, pooled multiple donor, pathogen reduced, frozen, each unit"
}, {
"code": "P9071",
"target": [ {
"code": "1014993",
"comment": "exact match",
"display": "Services in Pathology and Laboratory",
"equivalence": "equivalent"
} ],
"display": "Plasma (single donor), pathogen reduced, frozen, each unit"
}, {
"code": "P9073",
"target": [ {
"code": "1014993",
"comment": "exact match",
"display": "Services in Pathology and Laboratory",
"equivalence": "equivalent"
} ],
"display": "Platelets, pheresis, pathogen-reduced, each unit"
}, {
"code": "P9099",
"target": [ {
"code": "1014993",
"comment": "exact match",
"display": "Services in Pathology and Laboratory",
"equivalence": "equivalent"
} ],
"display": "Blood component or product not otherwise classified"
}, {
"code": "P9100",
"target": [ {
"code": "1014993",
"comment": "exact match",
"display": "Services in Pathology and Laboratory",
"equivalence": "equivalent"
} ],
"display": "Pathogen(s) test for platelets"
}, {
"code": "Level 2: P9603-P9604",
"target": [ {
"code": "1014993",
"comment": "exact match",
"display": "Services in Pathology and Laboratory",
"equivalence": "equivalent"
} ],
"display": "Travel Allowance for Specimen Collection"
}, {
"code": "P9603",
"target": [ {
"code": "1014993",
"comment": "exact match",
"display": "Services in Pathology and Laboratory",
"equivalence": "equivalent"
} ],
"display": "Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated miles actually travelled"
}, {
"code": "P9604",
"target": [ {
"code": "1014993",
"comment": "exact match",
"display": "Services in Pathology and Laboratory",
"equivalence": "equivalent"
} ],
"display": "Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated trip charge"
}, {
"code": "Level 2: P9612-P9615",
"target": [ {
"code": "1014993",
"comment": "exact match",
"display": "Services in Pathology and Laboratory",
"equivalence": "equivalent"
} ],
"display": "Catheterization for Specimen Collection"
}, {
"code": "P9612",
"target": [ {
"code": "1014993",
"comment": "exact match",
"display": "Services in Pathology and Laboratory",
"equivalence": "equivalent"
} ],
"display": "Catheterization for collection of specimen, single patient, all places of service"
}, {
"code": "P9615",
"target": [ {
"code": "1014993",
"comment": "exact match",
"display": "Services in Pathology and Laboratory",
"equivalence": "equivalent"
} ],
"display": "Catheterization for collection of specimen(s) (multiple patients)"
}, {
"code": "Q0113",
"target": [ {
"code": "87172",
"comment": "exact match",
"display": "Pinworm exam (eg, cellophane tape prep)",
"equivalence": "equivalent"
} ],
"display": "Pinworm examinations"
}, {
"code": "Level 3: V2630-V2632",
"target": [ {
"code": "66985",
"comment": "exact match",
"display": "Insertion of intraocular lens prosthesis (secondary implant), not associated with concurrent cataract removal",
"equivalence": "equivalent"
} ],
"display": "Intraocular Lenses"
}, {
"code": "V2630",
"target": [ {
"code": "66985",
"comment": "exact match",
"display": "Insertion of intraocular lens prosthesis (secondary implant), not associated with concurrent cataract removal",
"equivalence": "equivalent"
} ],
"display": "Anterior chamber intraocular lens"
}, {
"code": "V2631",
"target": [ {
"code": "66985",
"comment": "exact match",
"display": "Insertion of intraocular lens prosthesis (secondary implant), not associated with concurrent cataract removal",
"equivalence": "equivalent"
} ],
"display": "Iris supported intraocular lens"
}, {
"code": "V2632",
"target": [ {
"code": "66985",
"comment": "exact match",
"display": "Insertion of intraocular lens prosthesis (secondary implant), not associated with concurrent cataract removal",
"equivalence": "equivalent"
} ],
"display": "Posterior chamber intraocular lens"
} ],
"targetVersion": "2022"
} ],
"publisher": null,
"name": null,
"type": null,
"experimental": null,
"resourceType": "ConceptMap",
"title": null,
"package_version": "1.1.0",
"targetCanonical": "https://www.ama-assn.org/cpt",
"status": "active",
"id": "797d1f54-0958-4f35-ad23-31230e8be0dc",
"kind": null,
"url": "http://tigahealth.com/fhir/ConceptMap/hcpcs-cpt",
"version": "0.1.0"
}