|
LEVEL OF SERV
|
NEW
|
ESTB
|
|
LMT
|
90201
|
99211
|
|
STRT FWD
|
99202
|
99212
|
|
LOW COMP
|
99203
|
99213
|
|
MOD COMP
|
99204
|
99214
|
|
HIGH COMP
|
99205
|
99215
|
|
WELL VIST
|
NEW
|
ESTABLISH
|
|
Medicare
|
Prevention
|
Services
|
|
Annual Initial
|
G0438
|
Sub G0439
|
|
PAP
|
Q0091
|
|
|
Pelvic/Breast
|
G0101
|
|
|
Tobacco
|
3-10 min
|
G0436
|
|
Medicare UDS
|
G0434
|
ECG 99006
|
|
Hemoccult
|
quaiac
|
G0107
|
|
Hemoccult
|
Assay
|
G0328
|
|
Disability
|
Fit for Duty
|
99455
|
|
FUNCTIONAL
|
CLINIC
|
TESTING
|
|
Venipuncture
|
36415
|
|
|
Blood Glucose
|
Devise
|
82962
|
|
Blood Glucose
|
DipStik
|
82948
|
|
Pregnancy
|
Urine
|
81025
|
|
Strep Rapid
|
86403
|
|
|
Strep Rapid
|
Direct
|
87880
|
|
UA Complete
|
Non-auto
|
8100
|
|
PSA
|
G0103
|
|
|
Head
|
739.0
|
98925 (1-2)
|
|
Cervical
|
739.1
|
98925 (1-2)
|
|
Thoracic
|
739.2
|
98925 (1-2)
|
|
Lumbar
|
739.3
|
98925 (1-2)
|
|
Sacral
|
739.4
|
98925 (1-2)
|
|
Pelvic
|
739.5
|
98925 (1-2)
|
|
Lower Ext
|
739.6
|
98925 (1-2)
|
|
Upper Ext
|
739.7
|
98925 (1-2)
|
|
Rib
|
739.8
|
98925 (1-2)
|
|
Abdomen
|
739.9
|
98925 (1-2)
|
|
Tendinitis
|
20550
|
|
|
TP
|
1-2 Regions
|
20552
|
|
TP
|
3 Regions
|
20553
|
|
Jt. Injec
|
Small Jt.
|
20600
|
|
Knee/Hip
|
Major
|
20610
|
|
Wrist/hand
|
Intermediate
|
20605
|
|
SPG
|
Medicare
|
64505
|
|
Ganglion
|
Cyst
|
20612
|
|
SPG
|
Non-Medicare
|
64505
|
|
Facet Flouro
|
C/T
|
64490-92
|
|
L/S
|
64494-96
|
|
|
Ultrasound
|
C/T #1
|
0213T
|
|
Code: Lt/Rt
|
C/T #2
|
0214T
|
|
C/T #3
|
0215T
|
|
|
L/S #1
|
0216T
|
|
|
L/S #2
|
0217T
|
|
|
L/S #3
|
0218T
|
|
|
Omnipaque
|
Q9965
|
|
|
Celestone
|
J0702
|
|
Kenalog 40 mg 1cc= (10 mg)
|
J3301
|
|
Marcaine 0.5%
|
J0670
|
|
Lidocaine 1%
|
J2001
|
|
Omnipaque 240 mg
|
Q9966
|
|
Zofran 4mg IM
|
S0181
|
|
EPI 1 ml Ampule
|
J0170
|
|
Atropine Sulfate 0.3 mg
|
J0460
|
|
Ceftriaxone 750 mg IM
|
J0697
|
|
Methylprednisolone 40 mg
|
J1020
|
|
Dexamethazone
|
J1100
|
|
B12 1000 mcg
|
J3420
|
|
Hylan G-F 20
|
J7320
|
|
Synvisc
|
J7322
|
|
Orthovisc
|
J7324
|
|
Supartz 25 mg/2.5 ml
|
J7321
|
|
Nebulizer Tx
|
E0510
|
|
Toradol 15 mg
|
J1885
|
|
I/D Abscess
|
10060
|
|
Removal Skin Tag
|
11200-01
|
|
Shave Skin Lesion
|
11300
|
|
Subungal Hematoma
|
11750
|
|
Nail Removal
|
11732
|
|
Paronychial Incision
|
11765
|
|
Wound Repair Simple
|
12001
|
|
Suture Removal
|
15851
|
|
Burn Simple
|
16020
|
|
Destruction Lesion
|
17004
|
|
Destruction Lesion Cyro
|
17340
|
|
Destruction Lesion Face Cryo
|
19105
|
|
Injection Tendon, Lig, Cyst
|
20550
|
|
Arthrocentesis Asp.
|
20600
|
|
Aspiration Cyst
|
20612
|
|
Nebulizer
|
E0510
|
|
Prolonged treatment
|
99354
|
|
Pre-op Clearance 15
|
99241
|
|
Pre-op Clearance 20
|
99242
|
|
Pre-op Clearance
|
99243
|
|
15 min
|
99401
|
|
30 min
|
99402
|
|
45 min
|
99403
|
|
60 min
|
99404
|
|
Hep A Over 2 under 5
|
90633
|
|
HIB
|
82270
|
|
HPV Gardasil 11-18
|
90649
|
|
Pregnancy Test Urine
|
81025
|
|
Rapid Strep
|
87880
|
|
UA
|
81002
|
|
Specimen Collection
|
99000
|
|
Venipuncture
|
36415
|
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