Click here for more sample CPC practice exam questions with Full Rationale Answers

Practice Exam

Click here for more sample CPC practice exam questions and answers with full rationale

Practice Exam

CPC Practice Exam and Study Guide Package

Practice Exam

What makes a good CPC Practice Exam? Questions and Answers with Full Rationale

CPC Exam Review Video

Laureen shows you her proprietary “Bubbling and Highlighting Technique”

Download your Free copy of my "Medical Coding From Home Ebook" at the top right corner of this page

Practice Exam

2018 CPC Practice Exam Answer Key 150 Questions With Full Rationale (HCPCS, ICD-9-CM, ICD-10, CPT Codes) Click here for more sample CPC practice exam questions with Full Rationale Answers

Practice Exam

Click here for more sample CPC practice exam questions and answers with full rationale

Flu Vaccine Codes and Payments Effective Aug. 1

Is your billing office ready for the 2022-2023 influenza season? For the 2022-2023 influenza season, the Centers for Disease Control and Prevention (CDC) recommends everyone 6 months of age and older be vaccinated against the flu “ideally by the end of October.” This advice has not changed from previous years, but the Medicare Part B […]

The post Flu Vaccine Codes and Payments Effective Aug. 1 appeared first on AAPC Knowledge Center.

AAPC Knowledge Center

New Monkeypox Codes Effective Immediately

The CPT® Editorial Panel approved 2 vaccine codes and 1 lab code. In response to the monkeypox outbreak, the American Medical Association (AMA) has published three new CPT® codes, effective July 26, 2022, to report lab testing and vaccination. Learn the Lab Code Labs should get familiar with 87593 Infectious agent detection by nucleic acid […]

The post New Monkeypox Codes Effective Immediately appeared first on AAPC Knowledge Center.

AAPC Knowledge Center

New CLIA Waived Tests Effective October 1, 2020

There are five newly-added waived complexity tests under the Clinical Laboratory Improvements Amendments of 1988 (CLIA). These tests go into effect Oct. 1 and will be implemented by Medicare Administrative Contractors by Oct. 5. CLIA regulations require a facility to be certified for each test performed. To ensure that Medicare and Medicaid only pay for […]

The post New CLIA Waived Tests Effective October 1, 2020 appeared first on AAPC Knowledge Center.

AAPC Knowledge Center

New COVID-19 Test Codes Effective Immediately

Just when you thought you had all the COVID-19 coding for laboratory testing figured out — hold the phone — there are three new CPT® codes. These newest codes are effective June 25, 2020. CPT® Code Long Descriptor 0223U Infectious disease (bacterial or viral respiratory tract infection), pathogen-specific nucleic acid (DNA or RNA), 22 targets […]

The post New COVID-19 Test Codes Effective Immediately appeared first on AAPC Knowledge Center.

AAPC Knowledge Center

2020 ICD-10 CM Changes Effective from October 1, 2019

New Codes

D75.A Glucose-6-phosphatedehydrogenase(G6PD)deficiencywithoutanemia
D81.30 Adenosinedeaminasedeficiency,unspecified
D81.31 Severecombinedimmunodeficiencyduetoadenosinedeaminasedeficiency
D81.32 Adenosinedeaminase2deficiency
D81.39 Otheradenosinedeaminasedeficiency
I26.93 Singlesubsegmentalpulmonaryembolismwithoutacutecorpulmonale
I26.94 Multiplesubsegmentalpulmonaryemboliwithoutacutecorpulmonale
I48.11 Longstandingpersistentatrialfibrillation
I48.19 Otherpersistentatrialfibrillation
I48.20 Chronicatrialfibrillation,unspecified
I48.21 Permanentatrialfibrillation
I80.24 Phlebitisandthrombophlebitisofperonealvein
I80.241 Phlebitisandthrombophlebitisofrightperonealvein
I80.242 Phlebitisandthrombophlebitisofleftperonealvein
I80.243 Phlebitisandthrombophlebitisofperonealvein,bilateral
I80.249 Phlebitisandthrombophlebitisofunspecifiedperonealvein
I80.25 Phlebitisandthrombophlebitisofcalfmuscularvein
I80.251 Phlebitisandthrombophlebitisofrightcalfmuscularvein
I80.252 Phlebitisandthrombophlebitisofleftcalfmuscularvein
I80.253 Phlebitisandthrombophlebitisofcalfmuscularvein,bilateral
I80.259 Phlebitisandthrombophlebitisofunspecifiedcalfmuscularvein
I82.45 Acuteembolismandthrombosisofperonealvein
I82.451 Acuteembolismandthrombosisofrightperonealvein
I82.452 Acuteembolismandthrombosisofleftperonealvein
I82.453 Acuteembolismandthrombosisofperonealvein,bilateral
I82.459 Acuteembolismandthrombosisofunspecifiedperonealvein
I82.46 Acuteembolismandthrombosisofcalfmuscularvein
I82.461 Acuteembolismandthrombosisofrightcalfmuscularvein
I82.462 Acuteembolismandthrombosisofleftcalfmuscularvein
I82.463 Acuteembolismandthrombosisofcalfmuscularvein,bilateral
I82.469 Acuteembolismandthrombosisofunspecifiedcalfmuscularvein
I82.55 Chronicembolismandthrombosisofperonealvein
I82.551 Chronicembolismandthrombosisofrightperonealvein
I82.552 Chronicembolismandthrombosisofleftperonealvein
I82.553 Chronicembolismandthrombosisofperonealvein,bilateral
I82.559 Chronicembolismandthrombosisofunspecifiedperonealvein
I82.56 Chronicembolismandthrombosisofcalfmuscularvein
I82.561 Chronicembolismandthrombosisofrightcalfmuscularvein
I82.562 Chronicembolismandthrombosisofleftcalfmuscularvein
I82.563 Chronicembolismandthrombosisofcalfmuscularvein,bilateral
I82.569 Chronicembolismandthrombosisofunspecifiedcalfmuscularvein
L89.006 Pressure-induceddeeptissuedamageofunspecifiedelbow
L89.016 Pressure-induceddeeptissuedamageofrightelbow
L89.026 Pressure-induceddeeptissuedamageofleftelbow
L89.106 Pressure-induceddeeptissuedamageofunspecifiedpartofback
L89.116 Pressure-induceddeeptissuedamageofrightupperback
L89.126 Pressure-induceddeeptissuedamageofleftupperback
L89.136 Pressure-induceddeeptissuedamageofrightlowerback
L89.146 Pressure-induceddeeptissuedamageofleftlowerback
L89.156 Pressure-induceddeeptissuedamageofsacralregion
L89.206 Pressure-induceddeeptissuedamageofunspecifiedhip
L89.216 Pressure-induceddeeptissuedamageofrighthip
L89.226 Pressure-induceddeeptissuedamageoflefthip
L89.306 Pressure-induceddeeptissuedamageofunspecifiedbuttock
L89.316 Pressure-induceddeeptissuedamageofrightbuttock
L89.326 Pressure-induceddeeptissuedamageofleftbuttock
L89.46 Pressure-induceddeeptissuedamageofcontiguoussiteofback,buttockandhip
L89.506 Pressure-induceddeeptissuedamageofunspecifiedankle
L89.516 Pressure-induceddeeptissuedamageofrightankle
L89.526 Pressure-induceddeeptissuedamageofleftankle
L89.606 Pressure-induceddeeptissuedamageofunspecifiedheel
L89.616 Pressure-induceddeeptissuedamageofrightheel
L89.626 Pressure-induceddeeptissuedamageofleftheel
L89.816 Pressure-induceddeeptissuedamageofhead
L89.896 Pressure-induceddeeptissuedamageofothersite
L89.96 Pressure-induceddeeptissuedamageofunspecifiedsite
N63.15 Unspecifiedlumpintherightbreast,overlappingquadrants
N63.25 Unspecifiedlumpintheleftbreast,overlappingquadrants
N99.85 Postendometrialablationsyndrome
Q66.00 Congenitaltalipesequinovarus,unspecifiedfoot
Q66.01 Congenitaltalipesequinovarus,rightfoot
Q66.02 Congenitaltalipesequinovarus,leftfoot
Q66.10 Congenitaltalipescalcaneovarus,unspecifiedfoot
Q66.11 Congenitaltalipescalcaneovarus,rightfoot
Q66.12 Congenitaltalipescalcaneovarus,leftfoot
Q66.211 Congenitalmetatarsusprimusvarus,rightfoot
Q66.212 Congenitalmetatarsusprimusvarus,leftfoot
Q66.219 Congenitalmetatarsusprimusvarus,unspecifiedfoot
Q66.221 Congenitalmetatarsusadductus,rightfoot
Q66.222 Congenitalmetatarsusadductus,leftfoot
Q66.229 Congenitalmetatarsusadductus,unspecifiedfoot
Q66.30 Othercongenitalvarusdeformitiesoffeet,unspecifiedfoot
Q66.31 Othercongenitalvarusdeformitiesoffeet,rightfoot
Q66.32 Othercongenitalvarusdeformitiesoffeet,leftfoot
Q66.40 Congenitaltalipescalcaneovalgus,unspecifiedfoot
Q66.41 Congenitaltalipescalcaneovalgus,rightfoot
Q66.42 Congenitaltalipescalcaneovalgus,leftfoot
Q66.70 Congenitalpescavus,unspecifiedfoot
Q66.71 Congenitalpescavus,rightfoot
Q66.72 Congenitalpescavus,leftfoot
Q66.90 Congenitaldeformityoffeet,unspecified,unspecifiedfoot
Q66.91 Congenitaldeformityoffeet,unspecified,rightfoot
Q66.92 Congenitaldeformityoffeet,unspecified,leftfoot
Q79.60 Ehlers-Danlossyndrome,unspecified
Q79.61 ClassicalEhlers-Danlossyndrome
Q79.62 HypermobileEhlers-Danlossyndrome
Q79.63 VascularEhlers-Danlossyndrome
Q79.69 OtherEhlers-Danlossyndromes
Q87.11 Prader-Willisyndrome
Q87.19 Othercongenitalmalformationsyndromespredominantlyassociatedwithshortstature
R11.15 Cyclicalvomitingsyndromeunrelatedtomigraine
R82.81 Pyuria
R82.89 Otherabnormalfindingsoncytologicalandhistologicalexaminationofurine
S02.12 Fractureoforbitalroof
S02.121 Fractureoforbitalroof,rightside
S02.121A Fractureoforbitalroof,rightside,initialencounterforclosedfracture
S02.121B Fractureoforbitalroof,rightside,initialencounterforopenfracture
S02.121D Fractureoforbitalroof,rightside,subsequentencounterforfracturewithroutinehealing
S02.121G Fractureoforbitalroof,rightside,subsequentencounterforfracturewithdelayedhealing
S02.121K Fractureoforbitalroof,rightside,subsequentencounterforfracturewithnonunion
S02.121S Fractureoforbitalroof,rightside,sequela
S02.122 Fractureoforbitalroof,leftside
S02.122A Fractureoforbitalroof,leftside,initialencounterforclosedfracture
S02.122B Fractureoforbitalroof,leftside,initialencounterforopenfracture
S02.122D Fractureoforbitalroof,leftside,subsequentencounterforfracturewithroutinehealing
S02.122G Fractureoforbitalroof,leftside,subsequentencounterforfracturewithdelayedhealing
S02.122K Fractureoforbitalroof,leftside,subsequentencounterforfracturewithnonunion
S02.122S Fractureoforbitalroof,leftside,sequela
S02.129 Fractureoforbitalroof,unspecifiedside
S02.129A Fractureoforbitalroof,unspecifiedside,initialencounterforclosedfracture
S02.129B Fractureoforbitalroof,unspecifiedside,initialencounterforopenfracture
S02.129D Fractureoforbitalroof,unspecifiedside,subsequentencounterforfracturewithroutinehealing
S02.129G Fractureoforbitalroof,unspecifiedside,subsequentencounterforfracturewithdelayedhealing
S02.129K Fractureoforbitalroof,unspecifiedside,subsequentencounterforfracturewithnonunion
S02.129S Fractureoforbitalroof,unspecifiedside,sequela
S02.83 Fractureofmedialorbitalwall
S02.831 Fractureofmedialorbitalwall,rightside
S02.831A Fractureofmedialorbitalwall,rightside,initialencounterforclosedfracture
S02.831B Fractureofmedialorbitalwall,rightside,initialencounterforopenfracture
S02.831D Fractureofmedialorbitalwall,rightside,subsequentencounterforfracturewithroutinehealing
S02.831G Fractureofmedialorbitalwall,rightside,subsequentencounterforfracturewithdelayedhealing
S02.831K Fractureofmedialorbitalwall,rightside,subsequentencounterforfracturewithnonunion
S02.831S Fractureofmedialorbitalwall,rightside,sequela
S02.832 Fractureofmedialorbitalwall,leftside
S02.832A Fractureofmedialorbitalwall,leftside,initialencounterforclosedfracture
S02.832B Fractureofmedialorbitalwall,leftside,initialencounterforopenfracture
S02.832D Fractureofmedialorbitalwall,leftside,subsequentencounterforfracturewithroutinehealing
S02.832G Fractureofmedialorbitalwall,leftside,subsequentencounterforfracturewithdelayedhealing
S02.832K Fractureofmedialorbitalwall,leftside,subsequentencounterforfracturewithnonunion
S02.832S Fractureofmedialorbitalwall,leftside,sequela
S02.839 Fractureofmedialorbitalwall,unspecifiedside
S02.839A Fractureofmedialorbitalwall,unspecifiedside,initialencounterforclosedfracture
S02.839B Fractureofmedialorbitalwall,unspecifiedside,initialencounterforopenfracture
S02.839D Fractureofmedialorbitalwall,unspecifiedside,subsequentencounterforfracturewithroutinehealing
S02.839G Fractureofmedialorbitalwall,unspecifiedside,subsequentencounterforfracturewithdelayedhealing
S02.839K Fractureofmedialorbitalwall,unspecifiedside,subsequentencounterforfracturewithnonunion
S02.839S Fractureofmedialorbitalwall,unspecifiedside,sequela
S02.84 Fractureoflateralorbitalwall
S02.841 Fractureoflateralorbitalwall,rightside
S02.841A Fractureoflateralorbitalwall,rightside,initialencounterforclosedfracture
S02.841B Fractureoflateralorbitalwall,rightside,initialencounterforopenfracture
S02.841D Fractureoflateralorbitalwall,rightside,subsequentencounterforfracturewithroutinehealing
S02.841G Fractureoflateralorbitalwall,rightside,subsequentencounterforfracturewithdelayedhealing
S02.841K Fractureoflateralorbitalwall,rightside,subsequentencounterforfracturewithnonunion
S02.841S Fractureoflateralorbitalwall,rightside,sequela
S02.842 Fractureoflateralorbitalwall,leftside
S02.842A Fractureoflateralorbitalwall,leftside,initialencounterforclosedfracture
S02.842B Fractureoflateralorbitalwall,leftside,initialencounterforopenfracture
S02.842D Fractureoflateralorbitalwall,leftside,subsequentencounterforfracturewithroutinehealing
S02.842G Fractureoflateralorbitalwall,leftside,subsequentencounterforfracturewithdelayedhealing
S02.842K Fractureoflateralorbitalwall,leftside,subsequentencounterforfracturewithnonunion
S02.842S Fractureoflateralorbitalwall,leftside,sequela
S02.849 Fractureoflateralorbitalwall,unspecifiedside
S02.849A Fractureoflateralorbitalwall,unspecifiedside,initialencounterforclosedfracture
S02.849B Fractureoflateralorbitalwall,unspecifiedside,initialencounterforopenfracture
S02.849D Fractureoflateralorbitalwall,unspecifiedside,subsequentencounterforfracturewithroutinehealing
S02.849G Fractureoflateralorbitalwall,unspecifiedside,subsequentencounterforfracturewithdelayedhealing
S02.849K Fractureoflateralorbitalwall,unspecifiedside,subsequentencounterforfracturewithnonunion
S02.849S Fractureoflateralorbitalwall,unspecifiedside,sequela
S02.85 Fractureoforbit,unspecified
S02.85XA Fractureoforbit,unspecified,initialencounterforclosedfracture
S02.85XB Fractureoforbit,unspecified,initialencounterforopenfracture
S02.85XD Fractureoforbit,unspecified,subsequentencounterforfracturewithroutinehealing
S02.85XG Fractureoforbit,unspecified,subsequentencounterforfracturewithdelayedhealing
S02.85XK Fractureoforbit,unspecified,subsequentencounterforfracturewithnonunion
S02.85XS Fractureoforbit,unspecified,sequela
T50.91 Poisoningby,adverseeffectofandunderdosingofmultipleunspecifieddrugs,medicamentsandbiologicalsubstances
T50.911 Poisoningbymultipleunspecifieddrugs,medicamentsandbiologicalsubstances,accidental(unintentional)
T50.911A Poisoningbymultipleunspecifieddrugs,medicamentsandbiologicalsubstances,accidental(unintentional),initialencounter
T50.911D Poisoningbymultipleunspecifieddrugs,medicamentsandbiologicalsubstances,accidental(unintentional),subsequentencounter
T50.911S Poisoningbymultipleunspecifieddrugs,medicamentsandbiologicalsubstances,accidental(unintentional),sequela
T50.912 Poisoningbymultipleunspecifieddrugs,medicamentsandbiologicalsubstances,intentionalself-harm
T50.912A Poisoningbymultipleunspecifieddrugs,medicamentsandbiologicalsubstances,intentionalself-harm,initialencounter
T50.912D Poisoningbymultipleunspecifieddrugs,medicamentsandbiologicalsubstances,intentionalself-harm,subsequentencounter
T50.912S Poisoningbymultipleunspecifieddrugs,medicamentsandbiologicalsubstances,intentionalself-harm,sequela
T50.913 Poisoningbymultipleunspecifieddrugs,medicamentsandbiologicalsubstances,assault
T50.913A Poisoningbymultipleunspecifieddrugs,medicamentsandbiologicalsubstances,assault,initialencounter
T50.913D Poisoningbymultipleunspecifieddrugs,medicamentsandbiologicalsubstances,assault,subsequentencounter
T50.913S Poisoningbymultipleunspecifieddrugs,medicamentsandbiologicalsubstances,assault,sequela
T50.914 Poisoningbymultipleunspecifieddrugs,medicamentsandbiologicalsubstances,undetermined
T50.914A Poisoningbymultipleunspecifieddrugs,medicamentsandbiologicalsubstances,undetermined,initialencounter
T50.914D Poisoningbymultipleunspecifieddrugs,medicamentsandbiologicalsubstances,undetermined,subsequentencounter
T50.914S Poisoningbymultipleunspecifieddrugs,medicamentsandbiologicalsubstances,undetermined,sequela
T50.915 Adverseeffectofmultipleunspecifieddrugs,medicamentsandbiologicalsubstances
T50.915A Adverseeffectofmultipleunspecifieddrugs,medicamentsandbiologicalsubstances,initialencounter
T50.915D Adverseeffectofmultipleunspecifieddrugs,medicamentsandbiologicalsubstances,subsequentencounter
T50.915S Adverseeffectofmultipleunspecifieddrugs,medicamentsandbiologicalsubstances,sequela
T50.916 Underdosingofmultipleunspecifieddrugs,medicamentsandbiologicalsubstances
T50.916A Underdosingofmultipleunspecifieddrugs,medicamentsandbiologicalsubstances,initialencounter
T50.916D Underdosingofmultipleunspecifieddrugs,medicamentsandbiologicalsubstances,subsequentencounter
T50.916S Underdosingofmultipleunspecifieddrugs,medicamentsandbiologicalsubstances,sequela
T67.01 Heatstrokeandsunstroke
T67.01XA Heatstrokeandsunstroke,initialencounter
T67.01XD Heatstrokeandsunstroke,subsequentencounter
T67.01XS Heatstrokeandsunstroke,sequela
T67.02 Exertionalheatstroke
T67.02XA Exertionalheatstroke,initialencounter
T67.02XD Exertionalheatstroke,subsequentencounter
T67.02XS Exertionalheatstroke,sequela
T67.09 Otherheatstrokeandsunstroke
T67.09XA Otherheatstrokeandsunstroke,initialencounter
T67.09XD Otherheatstrokeandsunstroke,subsequentencounter
T67.09XS Otherheatstrokeandsunstroke,sequela
Y35.009 Legalinterventioninvolvingunspecifiedfirearmdischarge,unspecifiedpersoninjured
Y35.009A Legalinterventioninvolvingunspecifiedfirearmdischarge,unspecifiedpersoninjured,initialencounter
Y35.009D Legalinterventioninvolvingunspecifiedfirearmdischarge,unspecifiedpersoninjured,subsequentencounter
Y35.009S Legalinterventioninvolvingunspecifiedfirearmdischarge,unspecifiedpersoninjured,sequela
Y35.019 Legalinterventioninvolvinginjurybymachinegun,unspecifiedpersoninjured
Y35.019A Legalinterventioninvolvinginjurybymachinegun,unspecifiedpersoninjured,initialencounter
Y35.019D Legalinterventioninvolvinginjurybymachinegun,unspecifiedpersoninjured,subsequentencounter
Y35.019S Legalinterventioninvolvinginjurybymachinegun,unspecifiedpersoninjured,sequela
Y35.029 Legalinterventioninvolvinginjurybyhandgun,unspecifiedpersoninjured
Y35.029A Legalinterventioninvolvinginjurybyhandgun,unspecifiedpersoninjured,initialencounter
Y35.029D Legalinterventioninvolvinginjurybyhandgun,unspecifiedpersoninjured,subsequentencounter
Y35.029S Legalinterventioninvolvinginjurybyhandgun,unspecifiedpersoninjured,sequela
Y35.039 Legalinterventioninvolvinginjurybyriflepellet,unspecifiedpersoninjured
Y35.039A Legalinterventioninvolvinginjurybyriflepellet,unspecifiedpersoninjured,initialencounter
Y35.039D Legalinterventioninvolvinginjurybyriflepellet,unspecifiedpersoninjured,subsequentencounter
Y35.039S Legalinterventioninvolvinginjurybyriflepellet,unspecifiedpersoninjured,sequela
Y35.049 Legalinterventioninvolvinginjurybyrubberbullet,unspecifiedpersoninjured
Y35.049A Legalinterventioninvolvinginjurybyrubberbullet,unspecifiedpersoninjured,initialencounter
Y35.049D Legalinterventioninvolvinginjurybyrubberbullet,unspecifiedpersoninjured,subsequentencounter
Y35.049S Legalinterventioninvolvinginjurybyrubberbullet,unspecifiedpersoninjured,sequela
Y35.099 Legalinterventioninvolvingotherfirearmdischarge,unspecifiedpersoninjured
Y35.099A Legalinterventioninvolvingotherfirearmdischarge,unspecifiedpersoninjured,initialencounter
Y35.099D Legalinterventioninvolvingotherfirearmdischarge,unspecifiedpersoninjured,subsequentencounter
Y35.099S Legalinterventioninvolvingotherfirearmdischarge,unspecifiedpersoninjured,sequela
Y35.109 Legalinterventioninvolvingunspecifiedexplosives,unspecifiedpersoninjured
Y35.109A Legalinterventioninvolvingunspecifiedexplosives,unspecifiedpersoninjured,initialencounter
Y35.109D Legalinterventioninvolvingunspecifiedexplosives,unspecifiedpersoninjured,subsequentencounter
Y35.109S Legalinterventioninvolvingunspecifiedexplosives,unspecifiedpersoninjured,sequela
Y35.119 Legalinterventioninvolvinginjurybydynamite,unspecifiedpersoninjured
Y35.119A Legalinterventioninvolvinginjurybydynamite,unspecifiedpersoninjured,initialencounter
Y35.119D Legalinterventioninvolvinginjurybydynamite,unspecifiedpersoninjured,subsequentencounter
Y35.119S Legalinterventioninvolvinginjurybydynamite,unspecifiedpersoninjured,sequela
Y35.129 Legalinterventioninvolvinginjurybyexplosiveshell,unspecifiedpersoninjured
Y35.129A Legalinterventioninvolvinginjurybyexplosiveshell,unspecifiedpersoninjured,initialencounter
Y35.129D Legalinterventioninvolvinginjurybyexplosiveshell,unspecifiedpersoninjured,subsequentencounter
Y35.129S Legalinterventioninvolvinginjurybyexplosiveshell,unspecifiedpersoninjured,sequela
Y35.199 Legalinterventioninvolvingotherexplosives,unspecifiedpersoninjured
Y35.199A Legalinterventioninvolvingotherexplosives,unspecifiedpersoninjured,initialencounter
Y35.199D Legalinterventioninvolvingotherexplosives,unspecifiedpersoninjured,subsequentencounter
Y35.199S Legalinterventioninvolvingotherexplosives,unspecifiedpersoninjured,sequela
Y35.209 Legalinterventioninvolvingunspecifiedgas,unspecifiedpersoninjured
Y35.209A Legalinterventioninvolvingunspecifiedgas,unspecifiedpersoninjured,initialencounter
Y35.209D Legalinterventioninvolvingunspecifiedgas,unspecifiedpersoninjured,subsequentencounter
Y35.209S Legalinterventioninvolvingunspecifiedgas,unspecifiedpersoninjured,sequela
Y35.219 Legalinterventioninvolvinginjurybyteargas,unspecifiedpersoninjured
Y35.219A Legalinterventioninvolvinginjurybyteargas,unspecifiedpersoninjured,initialencounter
Y35.219D Legalinterventioninvolvinginjurybyteargas,unspecifiedpersoninjured,subsequentencounter
Y35.219S Legalinterventioninvolvinginjurybyteargas,unspecifiedpersoninjured,sequela
Y35.299 Legalinterventioninvolvingothergas,unspecifiedpersoninjured
Y35.299A Legalinterventioninvolvingothergas,unspecifiedpersoninjured,initialencounter
Y35.299D Legalinterventioninvolvingothergas,unspecifiedpersoninjured,subsequentencounter
Y35.299S Legalinterventioninvolvingothergas,unspecifiedpersoninjured,sequela
Y35.309 Legalinterventioninvolvingunspecifiedbluntobjects,unspecifiedpersoninjured
Y35.309A Legalinterventioninvolvingunspecifiedbluntobjects,unspecifiedpersoninjured,initialencounter
Y35.309D Legalinterventioninvolvingunspecifiedbluntobjects,unspecifiedpersoninjured,subsequentencounter
Y35.309S Legalinterventioninvolvingunspecifiedbluntobjects,unspecifiedpersoninjured,sequela
Y35.319 Legalinterventioninvolvingbaton,unspecifiedpersoninjured
Y35.319A Legalinterventioninvolvingbaton,unspecifiedpersoninjured,initialencounter
Y35.319D Legalinterventioninvolvingbaton,unspecifiedpersoninjured,subsequentencounter
Y35.319S Legalinterventioninvolvingbaton,unspecifiedpersoninjured,sequela
Y35.399 Legalinterventioninvolvingotherbluntobjects,unspecifiedpersoninjured
Y35.399A Legalinterventioninvolvingotherbluntobjects,unspecifiedpersoninjured,initialencounter
Y35.399D Legalinterventioninvolvingotherbluntobjects,unspecifiedpersoninjured,subsequentencounter
Y35.399S Legalinterventioninvolvingotherbluntobjects,unspecifiedpersoninjured,sequela
Y35.409 Legalinterventioninvolvingunspecifiedsharpobjects,unspecifiedpersoninjured
Y35.409A Legalinterventioninvolvingunspecifiedsharpobjects,unspecifiedpersoninjured,initialencounter
Y35.409D Legalinterventioninvolvingunspecifiedsharpobjects,unspecifiedpersoninjured,subsequentencounter
Y35.409S Legalinterventioninvolvingunspecifiedsharpobjects,unspecifiedpersoninjured,sequela
Y35.419 Legalinterventioninvolvingbayonet,unspecifiedpersoninjured
Y35.419A Legalinterventioninvolvingbayonet,unspecifiedpersoninjured,initialencounter
Y35.419D Legalinterventioninvolvingbayonet,unspecifiedpersoninjured,subsequentencounter
Y35.419S Legalinterventioninvolvingbayonet,unspecifiedpersoninjured,sequela
Y35.499 Legalinterventioninvolvingothersharpobjects,unspecifiedpersoninjured
Y35.499A Legalinterventioninvolvingothersharpobjects,unspecifiedpersoninjured,initialencounter
Y35.499D Legalinterventioninvolvingothersharpobjects,unspecifiedpersoninjured,subsequentencounter
Y35.499S Legalinterventioninvolvingothersharpobjects,unspecifiedpersoninjured,sequela
Y35.819 Legalinterventioninvolvingmanhandling,unspecifiedpersoninjured
Y35.819A Legalinterventioninvolvingmanhandling,unspecifiedpersoninjured,initialencounter
Y35.819D Legalinterventioninvolvingmanhandling,unspecifiedpersoninjured,subsequentencounter
Y35.819S Legalinterventioninvolvingmanhandling,unspecifiedpersoninjured,sequela
Y35.83 Legalinterventioninvolvingaconductedenergydevice
Y35.831 Legalinterventioninvolvingaconductedenergydevice,lawenforcementofficialinjured
Y35.831A Legalinterventioninvolvingaconductedenergydevice,lawenforcementofficialinjured,initialencounter
Y35.831D Legalinterventioninvolvingaconductedenergydevice,lawenforcementofficialinjured,subsequentencounter
Y35.831S Legalinterventioninvolvingaconductedenergydevice,lawenforcementofficialinjured,sequela
Y35.832 Legalinterventioninvolvingaconductedenergydevice,bystanderinjured
Y35.832A Legalinterventioninvolvingaconductedenergydevice,bystanderinjured,initialencounter
Y35.832D Legalinterventioninvolvingaconductedenergydevice,bystanderinjured,subsequentencounter
Y35.832S Legalinterventioninvolvingaconductedenergydevice,bystanderinjured,sequela
Y35.833 Legalinterventioninvolvingaconductedenergydevice,suspectinjured
Y35.833A Legalinterventioninvolvingaconductedenergydevice,suspectinjured,initialencounter
Y35.833D Legalinterventioninvolvingaconductedenergydevice,suspectinjured,subsequentencounter
Y35.833S Legalinterventioninvolvingaconductedenergydevice,suspectinjured,sequela
Y35.839 Legalinterventioninvolvingaconductedenergydevice,unspecifiedpersoninjured
Y35.839A Legalinterventioninvolvingaconductedenergydevice,unspecifiedpersoninjured,initialencounter
Y35.839D Legalinterventioninvolvingaconductedenergydevice,unspecifiedpersoninjured,subsequentencounter
Y35.839S Legalinterventioninvolvingaconductedenergydevice,unspecifiedpersoninjured,sequela
Y35.99 Legalintervention,meansunspecified,unspecifiedpersoninjured
Y35.99XA Legalintervention,meansunspecified,unspecifiedpersoninjured,initialencounter
Y35.99XD Legalintervention,meansunspecified,unspecifiedpersoninjured,subsequentencounter
Y35.99XS Legalintervention,meansunspecified,unspecifiedpersoninjured,sequela
Z01.02 Encounterforexaminationofeyesandvisionfollowingfailedvisionscreening
Z01.020 Encounterforexaminationofeyesandvisionfollowingfailedvisionscreeningwithoutabnormalfindings
Z01.021 Encounterforexaminationofeyesandvisionfollowingfailedvisionscreeningwithabnormalfindings
Z11.7 Encounterfortestingforlatenttuberculosisinfection
Z22.7 Latenttuberculosis
Z71.84 Encounterforhealthcounselingrelatedtotravel
Z86.002 Personalhistoryofin-situneoplasmofotherandunspecifiedgenitalorgans
Z86.003 Personalhistoryofin-situneoplasmoforalcavity,esophagusandstomach
Z86.004 Personalhistoryofin-situneoplasmofotherandunspecifieddigestiveorgans
Z86.005 Personalhistoryofin-situneoplasmofmiddleearandrespiratorysystem
Z86.006 Personalhistoryofmelanomain-situ
Z86.007 Personalhistoryofin-situneoplasmofskin
Z86.15 Personalhistoryoflatenttuberculosisinfection
Z96.82 Presenceofneurostimulator

Revised Codes:

B96.21 Shigatoxin-producingEscherichiacoli[E.coli][STEC]O157asthecauseofdiseasesclassifiedelsewhere
B96.22 OtherspecifiedShigatoxin-producingEscherichiacoli[E.coli][STEC]asthecauseofdiseasesclassifiedelsewhere
B96.23 UnspecifiedShigatoxin-producingEscherichiacoli[E.coli][STEC]asthecauseofdiseasesclassifiedelsewhere
G43.A0 Cyclicalvomiting,inmigraine,notintractable
G43.A1 Cyclicalvomiting,inmigraine,intractable
I70.238 Atherosclerosisofnativearteriesofrightlegwithulcerationofotherpartoflowerleg
I70.248 Atherosclerosisofnativearteriesofleftlegwithulcerationofotherpartoflowerleg
J44.0 Chronicobstructivepulmonarydiseasewith(acute)lowerrespiratoryinfection
M50.120 Mid-cervicaldiscdisorder,unspecifiedlevel
M66.88 Spontaneousruptureofothertendons,othersites
M67.839 Otherspecifieddisordersofsynoviumandtendon,unspecifiedwrist
M77.5 Otherenthesopathyoffootandankle
M77.50 Otherenthesopathyofunspecifiedfootandankle
M77.51 Otherenthesopathyofrightfootandankle
M77.52 Otherenthesopathyofleftfootandankle
N35.814 Otheranteriorurethralstricture,male
R82.993 Hyperuricosuria
T40.906 Underdosingofunspecifiedpsychodysleptics[hallucinogens]
T40.906A Underdosingofunspecifiedpsychodysleptics[hallucinogens],initialencounter
T40.906D Underdosingofunspecifiedpsychodysleptics[hallucinogens],subsequentencounter
T40.906S Underdosingofunspecifiedpsychodysleptics[hallucinogens],sequela
T40.996 Underdosingofotherpsychodysleptics[hallucinogens]
T40.996A Underdosingofotherpsychodysleptics[hallucinogens],initialencounter
T40.996D Underdosingofotherpsychodysleptics[hallucinogens],subsequentencounter
T40.996S Underdosingofotherpsychodysleptics[hallucinogens],sequela
T44.1X6 Underdosingofotherparasympathomimetics[cholinergics]
T44.1X6A Underdosingofotherparasympathomimetics[cholinergics],initialencounter
T44.1X6D Underdosingofotherparasympathomimetics[cholinergics],subsequentencounter
T44.1X6S Underdosingofotherparasympathomimetics[cholinergics],sequela
V43.13 Carpassengerinjuredincollisionwithpick-uptruckinnontrafficaccident
V43.13XA Carpassengerinjuredincollisionwithpick-uptruckinnontrafficaccident,initialencounter
V43.13XD Carpassengerinjuredincollisionwithpick-uptruckinnontrafficaccident,subsequentencounter
V43.13XS Carpassengerinjuredincollisionwithpick-uptruckinnontrafficaccident,sequela
Z45.42 Encounterforadjustmentandmanagementofneurostimulator
Z68.43 Bodymassindex(BMI)50.0-59.9,adult

Deleted Codes:

H81.41 Vertigoofcentralorigin,rightear
H81.42 Vertigoofcentralorigin,leftear
H81.43 Vertigoofcentralorigin,bilateral
H81.49 Vertigoofcentralorigin,unspecifiedear
T67.0XXA Heatstrokeandsunstroke,initialencounter
T67.0XXD Heatstrokeandsunstroke,subsequentencounter
T67.0XXS Heatstrokeandsunstroke,sequela
See Also New Codes


Coding Ahead

HCPCS Codes Changes effective from October 1, 2019


The HCPCS code set is updated quarterly. CR 11422 informs MACs and providers of the latest updates to specific drug/biological HCPCS codes. The October 2019 quarterly HCPCS file includes forty-four (44) new HCPCS codes. Effective for claims with dates of service on or after October 1, 2019.

1) J0121
a. Short Descriptor: Inj., omadacycline, 1 mg
b. Long Descriptor: Injection, omadacycline, 1 mg
c. Type of Service (TOS): 1,P

2) J0122
a. Short Descriptor: Inj., eravacycline, 1 mg
b. Long Descriptor: Injection, eravacycline, 1 mg
c. TOS: 1,P

3) J0222
a. Short Descriptor: Inj., patisiran, 0.1 mg
b. Long Descriptor: Injection, Patisiran, 0.1 mg
c. TOS: 1

4) J0291
a. Short Descriptor: Inj., plazomicin, 5 mg
b. Long Descriptor: Injection, plazomicin, 5 mg
c. TOS: 1

5) J0593
a. Short Descriptor: Inj., lanadelumab-flyo, 1 mg
b. Long Descriptor: Injection, lanadelumab-flyo, 1 mg (code may be used for Medicare when drug administered under direct supervision of a physician, not for use when drug is self-administered)
c. TOS: 1

6) J1096
a. Short Descriptor: Dexametha opth insert 0.1 mg
b. Long Descriptor: Dexamethasone, lacrimal ophthalmic insert, 0.1 mg
c. TOS: 1

7) J1097
a. Short Descriptor: Phenylep ketorolac opth soln
b. Long Descriptor: Phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 ml
c. TOS: 1

8) J1303
a. Short Descriptor: Inj., ravulizumab-cwvz 10 mg
b. Long Descriptor: Injection, ravulizumab-cwvz, 10 mg
c. TOS: 1,P

9) J1943
a. Short Descriptor: Inj., aristada initio, 1 mg
b. Long Descriptor: Injection, aripiprazole lauroxil, (aristada initio), 1 mg
c. TOS: 1

10) J1944
a. Short Descriptor: Inj., aripirazole lauroxil 1 mg
b. Long Descriptor: Injection, aripiprazole lauroxil, (aristada), 1 mg
c. TOS: 1

11) J2798
a. Short Descriptor: Inj., perseris, 0.5 mg
b. Long Descriptor: Injection, risperidone, (perseris), 0.5 mg
c. TOS: 1,P

12) J3031
a. Short Descriptor: Inj., fremanezumab-vfrm 1 mg
b. Long Descriptor: Injection, fremanezumab-vfrm, 1 mg (code may be used for Medicare when drug administered under the direct supervision of a physician, not for use when drug is self-administered)
c. TOS: 1, P

13) J3111
a. Short Descriptor: Inj. romosozumab-aqqg 1 mg
b. Long descriptor: Injection, romosozumab-aqqg, 1 mg
c. TOS: 1

14) J7314
a. Short Descriptor: Inj., yutiq, 0.01 mg
b. Long Descriptor: Injection, fluocinolone acetonide, intravitreal implant (Yutiq), 0.01 mg
c. TOS: 1

15) J7331
a. Short Descriptor: Synojoynt, inj., 1 mg
b. Long Descriptor: Hyaluronan or derivative, synojoynt, for intra-articular injection, 1 mg
c. TOS: 1

16) J7332
a. Short Descriptor: Inj., triluron, 1 mg
b. Long Descriptor: Hyaluronan or derivative, triluron, for intra-articular injection, 1 mg
c. TOS: 1

17) J7401
a. Short Descriptor: Mometasone furoate sinus imp
b. Long Descriptor: Mometasone furoate sinus implant, 10 micrograms
c. TOS: 1

18) J9118
a. a. Short Descriptor: Inj. Calaspargase pegol-mknl
b. b. Long Descriptor: Injection, calaspargase pegol-mknl, 10 units
c. c. TOS: 1,P

19) J9119
a. Short Descriptor: Inj., cemiplimab-rwlc, 1 mg
b. Long Descriptor: Injection, cemiplimab-rwlc, 1 mg
c. TOS: 1

20) J9204
a. Short Descriptor: Inj, mogamulizumab-kpkc, 1 mg
b. Long Descriptor: Injection, mogamulizumab-kpkc, 1 mg
c. TOS: 1,P

21) J9210
a. Short Descriptor: Inj., emapalumab-lzsg, 1 mg
b. Long Descriptor: Injection, emapalumab-lzsg, 1 mg
c. TOS: 1 

22) J9269
a. Short Descriptor: Inj. tagraxofusp-erzs 10 mcg
b. Long Descriptor: Injection, tagraxofusp-erzs, 10 micrograms
c. TOS: 1

23) J9313
a. Short Descriptor: Inj., lumoxiti, 0.01 mg
b. Long Descriptor: Injection, moxetumomab pasudotox-tdfk, 0.01 mg
c. TOS: 1,P

24) Q4205
a. Short Descriptor: Membrane graft or wrap sq cm
b. Long Descriptor: Membrane graft or membrane wrap, per square centimeter
c. TOS: 1

25) Q4206
a. Short Descriptor: Fluid flow or fluid gf 1 cc
b. Long Descriptor: Fluid flow or fluid GF, 1 cc
c. TOS: 1

26) Q4208
a. Short Descriptor: Novafix per sq cm
b. Long Descriptor: Novafix, per square centimeter
c. TOS: 1

27) Q4209
a. Short Descriptor: Surgraft per sq cm
b. Long Descriptor: Surgraft, per square centimeter
c. TOS: 1

28) Q4210
a. Short Descriptor: Axolotl graf dualgraf sq cm
b. Long Descriptor: Axolotl graft or axolotl dualgraft, per square centimeter
c. TOS: 1

29) Q4211
a. Short Descriptor: Amnion bio or axobio sq cm
b. Long Descriptor: Amnion bio or Axobiomembrane, per square centimeter
c. TOS: 1

30) Q4212
a. Short Descriptor: Allogen, per cc
b. Long Descriptor: Allogen, per cc
c. TOS: 1

31) Q4213
a. Short Descriptor: Ascent, 0.5 mg
b. Long Descriptor: Ascent, 0.5 mg
c. TOS: 1 

32) Q4214
a. Short Descriptor: Cellesta cord per sq cm
b. Long Descriptor: Cellesta cord, per square centimeter
c. TOS: 1

33) Q4215
a. Short Descriptor: Axolotl ambient, cryo 0.1 mg
b. Long Descriptor: Axolotl ambient or axolotl cryo, 0.1 mg
c. TOS: 1

34) Q4216
a. Short Descriptor: Artacent cord per sq cm
b. Long Descriptor: Artacent cord, per square centimeter
c. TOS: 1

35) Q4217
a. Short Descriptor: Woundfix biowound plus xplus
b. Long Descriptor: Woundfix, BioWound, Woundfix Plus, BioWound Plus, Woundfix Xplus
or BioWound Xplus, per square centimeter
c. TOS: 1

36) Q4218
a. Short Descriptor: Surgicord per sq cm
b. Long Descriptor: Surgicord, per square centimeter
c. TOS: 1

37) Q4219
a. Short Descriptor: Surgigraft dual per sq cm
b. Long Descriptor: Surgigraft-dual, per square centimeter
c. TOS: 1

38) Q4220
a. Short Descriptor: Bellacell HD, Surederm sq cm
b. Long Descriptor: BellaCell HD or Surederm, per square centimeter
c. TOS: 1

39) Q4221
a. Short Descriptor: Amniowrap2 per sq cm
b. Long Descriptor: Amniowrap2, per square centimeter
c. TOS: 1

40) Q4222
a. Short Descriptor: Progenamatrix, per sq cm
b. Long Descriptor: Progenamatrix, per square centimeter
c. TOS: 1

41) Q4226
a. Short Descriptor: Myown harv prep proc sq cm
b. Long Descriptor: MyOwn skin, includes harvesting and preparation procedures, per square centimeter
c. TOS: 1 

42) Q5116
a. Short Descriptor: Inj., trazimera, 10 mg
b. Long Descriptor: Injection, trastuzumab-qyyp, biosimilar, (trazimera), 10 mg
c. TOS: 1,P

43) Q5117
a. Short Descriptor: Inj., kanjinti, 10 mg
b. Long Descriptor: Injection, trastuzumab-anns, biosimilar, (kanjinti), 10 mg
c. TOS: 1,P

44) Q5118
a.Short Descriptor: Inj., zirabev, 10 mg
b.Long Descriptor: Injection, bevacizumab-bvzr, biosimilar, (Zirabev), 10 mg
c. TOS: 1,P

HCPCS codes J1942 (Aripiprazole lauroxil 1mg/Injection, aripiprazole lauroxil, 1 mg) and S1090 (Mometasone sinus implant/Mometasone furoate sinus implant, 370 micrograms) are being discontinued effective October 1, 2019; and may not be used in submitting claims to Medicare with dates of service on or after that date.

Effective for claims with dates of service on or after October 1, 2019, the long and short descriptors for the following HCPCS codes will be modified. The TOS and all other indicators will remain the same.

1) J0641
a. New Short Descriptor: Inj., levoleucovorin, 0.5 mg
b. New Long Descriptor: Injection, levoleucovorin, 0.5 mg

2) J2794
a. New Short Descriptor: Inj., risperdal consta, 0.5 mg
b. New Long Descriptor: Injection, risperidone (risperdal consta), 0.5 mg

3) J7311
a. New Short Descriptor: Inj., retisert, 0.01 mg
b. New Long Descriptor: Injection, fluocinolone acetonide, intravitreal implant (retisert), 0.01
mg
9
4) J7313
a. New Short Descriptor: Inj., iluvien, 0.01 mg
b. New Long Descriptor: Injection, fluocinolone acetonide, intravitreal implant (Iluvien), 0.01
mg

5) Q4122
a. New Short Descriptor: Dermacell, awm, porous sq cm
b. New Long Descriptor: Dermacell, dermacell awm or dermacell awm porous, per square centimeter

6) Q4165
a. New Short Descriptor: Keramatrix, Kerasorb sq cm
b. New Long Descriptor: Keramatrix or kerasorb, per square centimeter 

7) Q4184
a. New Short Descriptor: Cellesta or duo per sq cm

b. New Long Descriptor: Cellesta or cellesta duo, per square centimeter


Coding Ahead

Upcoming HCPCS (DELETED/REVISED) Code Changes Effective from October 1, 2019

Deleted Codes:

J1942 Injection, aripiprazole lauroxil, 1 mg
S1090 Mometasone furoate sinus implant, 370 micrograms

Revised Codes:

J0641 Inj., levoleucovorin, 0.5 mg
J2794 Inj., risperdal consta, 0.5 mg
J7311 Inj., retisert, 0.01 mg
J7313 Inj., iluvien, 0.01 mg
Q4122 Dermacell, awm, porous sq cm
Q4165 Keramatrix, Kerasorb sq cm
Q4184 Cellesta or duo per sq cm


Coding Ahead

Upcoming HCPCS (NEW) Code Changes Effective from October 1, 2019

New Codes:

J0121 Injection, omadacycline, 1 mg
J0122 Injection, eravacycline, 1 mg
J0222 Injection, Patisiran, 0.1 mg
J0291 Injection, plazomicin, 5 mg
J0593 Injection, lanadelumab-flyo, 1 mg (code may be used for Medicare when drug administered under direct supervision of a physician, not for use when drug is self-administered)
J1096 Dexamethasone, lacrimal ophthalmic insert, 0.1 mg
J1097 phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 ml
J1303 Injection, ravulizumab-cwvz, 10 mg
J1943 Injection, aripiprazole lauroxil, (aristada initio), 1 mg
J1944 Injection, aripiprazole lauroxil, (aristada), 1 mg
J2798 Injection, risperidone, (perseris), 0.5 mg
J3031 Injection, fremanezumab-vfrm, 1 mg (code may be used for Medicare when drug administered under the direct supervision of a physician, not for use when drug is self-administered)
J3111 Injection, romosozumab-aqqg, 1 mg
J7314 Injection, fluocinolone acetonide, intravitreal implant (Yutiq), 0.01 mg
J7331 Hyaluronan or derivative, synojoynt, for intra-articular injection, 1 mg
J7332 Hyaluronan or derivative, triluron, for intra-articular injection, 1 mg
J7401 Mometasone furoate sinus implant, 10 micrograms
J9118 Injection, calaspargase pegol-mknl, 10 units
J9119 Injection, cemiplimab-rwlc, 1 mg
J9204 Injection, mogamulizumab-kpkc, 1 mg
J9210 Injection, emapalumab-lzsg, 1 mg
J9269 Injection, tagraxofusp-erzs, 10 micrograms
J9313 Injection, moxetumomab pasudotox-tdfk, 0.01 mg
Q4205 Membrane graft or membrane wrap, per square centimeter
Q4206 Fluid flow or fluid GF, 1 cc
Q4208 Novafix, per square cenitmeter
Q4209 Surgraft, per square centimeter
Q4210 Axolotl graft or axolotl dualgraft, per square centimeter
Q4211 Amnion bio or Axobiomembrane, per square centimeter
Q4212 Allogen, per cc
Q4213 Ascent, 0.5 mg
Q4214 Cellesta cord, per square centimeter
Q4215 Axolotl ambient or axolotl cryo, 0.1 mg
Q4216 Artacent cord, per square centimeter
Q4217 Woundfix, BioWound, Woundfix Plus, BioWound Plus, Woundfix Xplus or BioWound Xplus, per square centimeter
Q4218 Surgicord, per square centimeter
Q4219 Surgigraft-dual, per square centimeter
Q4220 BellaCell HD or Surederm, per square centimeter
Q4221 Amniowrap2, per square centimeter
Q4222 Progenamatrix, per square centimeter
Q4226 MyOwn skin, includes harvesting and preparation procedures, per square centimeter
Q5116 Injection, trastuzumab-qyyp, biosimilar, (trazimera), 10 mg
Q5117 Injection, trastuzumab-anns, biosimilar, (kanjinti), 10 mg
Q5118 Injection, bevacizumab-bvcr, biosimilar, (Zirabev), 10 mg


Coding Ahead

Upcoming CPT (DELETED) Code Changes Effective from October 1, 2019

Deleted Codes:


0104U Hereditary pan cancer (eg, hereditary breast and ovarian cancer, hereditary endometrial cancer, hereditary colorectal cancer), genomic sequence analysis panel utilizing a combination of NGS, Sanger, MLPA, and array CGH, with MRNA analytics to resolve variants of unknown significance when indicated (32 genes[sequencing and deletion/duplication], EPCAM and GREM1 [deletion/duplication only])

90619 Meningococcal conjugate vaccine, serogroups A, C, W, Y, quadrivalent, tetanus toxoid carrier (MenACWY-TT), for intramuscular use


Coding Ahead

Upcoming CPT (NEW) Code Changes Effective from October 1, 2019

New Codes:


0105U Nephrology (chronic kidney disease), multiplex electrochemiluminescent immunoassay (ECLIA) of tumor necrosis factor receptor 1A, receptor superfamily 2 (TNFR1, TNFR2), and kidney injury molecule-1 (KIM-1) combined with longitudinal clinical data, including APOL1 genotype if available, and plasma (isolated fresh or frozen), algorithm reported as probability score for rapid kidney function decline (RKFD)
0106U Gastric emptying, serial collection of 7 timed breath specimens, non-radioisotope carbon-13 (13C) spirulina substrate, analysis of each specimen by gas isotope ratio mass spectrometry, reported as rate of 13CO2 excretion
0107U Clostridium difficile toxin(s) antigen detection by immunoassay technique, stool, qualitative, multiple-step method
0108U Gastroenterology (Barrett’s esophagus), whole slide–digital imaging, including morphometric analysis, computer-assisted quantitative immunolabeling of 9 protein biomarkers (p16, AMACR, p53, CD68, COX-2, CD45RO, HIF1a, HER-2, K20) and morphology, formalin-fixed paraffin-embedded tissue, algorithm reported as risk of progression to high-grade dysplasia or cancer
0109U Infectious disease (Aspergillus species), real-time PCR for detection of DNA from 4 species (A. fumigatus, A. terreus, A. niger, and A. flavus), blood, lavage fluid, or tissue, qualitative reporting of presence or absence of each species
0110U Prescription drug monitoring, one or more oral oncology drug(s) and substances, definitive tandem mass spectrometry with chromatography, serum or plasma from capillary blood or venous blood, quantitative report with steady-state range for the prescribed drug(s) when detected
0111U Oncology (colon cancer), targeted KRAS (codons 12, 13, and 61) and NRAS (codons 12, 13, and 61) gene analysis utilizing formalin-fixed paraffin-embedded tissue
0112U Infectious agent detection and identification, targeted sequence analysis (16S and 18S rRNA genes) with drug-resistance gene
0113U Oncology (prostate), measurement of PCA3 and TMPRSS2-ERG in urine and PSA in serum following prostatic massage, by RNA amplification and fluorescence-based detection, algorithm reported as risk score
0114U Gastroenterology (Barrett’s esophagus), VIM and CCNA1 methylation analysis, esophageal cells, algorithm reported as likelihood for Barrett’s esophagus
0115U Respiratory infectious agent detection by nucleic acid (DNA and RNA), 18 viral types and subtypes and 2 bacterial targets, amplified probe technique, including multiplex reverse transcription for RNA targets, each analyte reported as detected or not detected
0116U Prescription drug monitoring, enzyme immunoassay of 35 or more drugs confirmed with LC-MS/MS, oral fluid, algorithm results reported as a patient-compliance measurement with risk of drug to drug interactions for prescribed medications
0117U Pain management, analysis of 11 endogenous analytes (methylmalonic acid, xanthurenic acid, homocysteine, pyroglutamic acid, vanilmandelate, 5-hydroxyindoleacetic acid, hydroxymethylglutarate, ethylmalonate, 3-hydroxypropyl mercapturic acid (3-HPMA), quinolinic acid, kynurenic acid), LC-MS/MS, urine, algorithm reported as a pain-index score with likelihood of atypical biochemical function associated with pain
0118U Transplantation medicine, quantification of donor-derived cell-free DNA using whole genome next-generation sequencing, plasma, reported as percentage of donor-derived cell-free DNA in the total cell-free DNA
0119U Cardiology, ceramides by liquid chromatography–tandem mass spectrometry, plasma, quantitative report with risk score for major cardiovascular events
0120U Oncology (B-cell lymphoma classification), mRNA, gene expression profiling by fluorescent probe hybridization of 58 genes (45 content and 13 housekeeping genes), formalin-fixed paraffin-embedded tissue, algorithm reported as likelihood for primary mediastinal B-cell lymphoma (PMBCL) and diffuse large B-cell lymphoma (DLBCL) with cell of origin subtyping in the latter
0121U Sickle cell disease, microfluidic flow adhesion (VCAM-1), whole blood
0122U Sickle cell disease, microfluidic flow adhesion (P-Selectin), whole blood
0123U Mechanical fragility, RBC, shear stress and spectral analysis profiling
0124U Fetal congenital abnormalities, biochemical assays of 3 analytes (free beta-hCG, PAPP-A, AFP), time-resolved fluorescence immunoassay, maternal dried-blood spot, algorithm reported as risk scores for fetal trisomies 13/18 and 21
0125U Fetal congenital abnormalities and perinatal complications, biochemical assays of 5 analytes (free beta-hCG, PAPP-A, AFP, placental growth factor, and inhibin-A), time-resolved fluorescence immunoassay, maternal serum, algorithm reported as risk scores for fetal trisomies 13/18, 21, and preeclampsia
0126U Fetal congenital abnormalities and perinatal complications, biochemical assays of 5 analytes (free beta-hCG, PAPP-A, AFP, placental growth factor, and inhibin-A), time-resolved fluorescence immunoassay, includes qualitative assessment of Y chromosome in cell-free fetal DNA, maternal serum and plasma, predictive algorithm reported as a risk scores for fetal trisomies 13/18, 21, and preeclampsia
0127U Obstetrics (preeclampsia), biochemical assays of 3 analytes (PAPP-A, AFP, and placental growth factor), time-resolved fluorescence immunoassay, maternal serum, predictive algorithm reported as a risk score for preeclampsia
0128U Obstetrics (preeclampsia), biochemical assays of 3 analytes (PAPP-A, AFP, and placental growth factor), time-resolved fluorescence immunoassay, includes qualitative assessment of Y chromosome in cell-free fetal DNA, maternal serum and plasma, predictive algorithm reported as a risk score for preeclampsia
0129U Hereditary breast cancer–related disorders (eg, hereditary breast cancer, hereditary ovarian cancer, hereditary endometrial cancer), genomic sequence analysis and deletion/duplication analysis panel (ATM, BRCA1, BRCA2, CDH1, CHEK2, PALB2, PTEN, and TP53)
0130U Hereditary colon cancer disorders (eg, Lynch syndrome, PTEN hamartoma syndrome, Cowden syndrome, familial adenomatosis polyposis), targeted mRNA sequence analysis panel (APC, CDH1, CHEK2, MLH1, MSH2, MSH6, MUTYH, PMS2, PTEN, and TP53) (List separately in addition to code for primary procedure)
0131U Hereditary breast cancer–related disorders (eg, hereditary breast cancer, hereditary ovarian cancer, hereditary endometrial cancer), targeted mRNA sequence analysis panel (13 genes) (List separately in addition to code for primary procedure)
0132U Hereditary ovarian cancer–related disorders (eg, hereditary breast cancer, hereditary ovarian cancer, hereditary endometrial cancer), targeted mRNA sequence analysis panel (17 genes) (List separately in addition to code for primary procedure)
0133U Hereditary prostate cancer–related disorders, targeted mRNA sequence analysis panel (11 genes) (List separately in addition to code for primary procedure)
0134U Hereditary pan cancer (eg, hereditary breast and ovarian cancer, hereditary endometrial cancer, hereditary colorectal cancer), targeted mRNA sequence analysis panel (18 genes) (List separately in addition to code for primary procedure)
0135U Hereditary gynecological cancer (eg, hereditary breast and ovarian cancer, hereditary endometrial cancer, hereditary colorectal cancer), targeted mRNA sequence analysis panel (12 genes) (List separately in addition to code for primary procedure)
0136U ATM (ataxia telangiectasia mutated) (eg, ataxia telangiectasia) mRNA sequence analysis (List separately in addition to code for primary procedure)
0137U PALB2 (partner and localizer of BRCA2) (eg, breast and pancreatic cancer) mRNA sequence analysis (List separately in addition to code for primary procedure)
0138U BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) mRNA sequence analysis (List separately in addition to code for primary procedure)

See Deleted Codes


Coding Ahead