Column 1 |
Column 2 |
STD Policy Statement |
B Mods Allowed |
87801 |
87653 |
HCPCS/CPT procedure code definition |
1 |
87490 |
83913 |
More extensive procedure |
1 |
87472 |
83913 |
More extensive procedure |
1 |
87641 |
83893 |
Misuse of column two code with column one code |
1 |
87498 |
83896 |
Misuse of column two code with column one code |
1 |
87562 |
83913 |
More extensive procedure |
1 |
87550 |
83913 |
More extensive procedure |
1 |
83913 |
80502 |
Standards of medical / surgical practice |
1 |
88305 |
89060 |
HCPCS/CPT coding manual instruction / guidelin |
1 |
87581 |
83913 |
More extensive procedure |
1 |
87801 |
87498 |
Misuse of column two code with column one code |
1 |
87498 |
83894 |
Misuse of column two code with column one code |
1 |
87498 |
83912 |
Misuse of column two code with column one code |
1 |
0146T |
0150T |
Misuse of column two code with column one code |
0 |
87640 |
83892 |
Misuse of column two code with column one code |
1 |
87529 |
83913 |
More extensive procedure |
1 |
87492 |
83913 |
More extensive procedure |
1 |
0151T |
0144T |
HCPCS/CPT coding manual instruction / guideline |
0 |
0149T |
0145T |
More extensive procedure |
0 |
87486 |
83913 |
More extensive procedure |
1 |
87653 |
83902 |
Misuse of column two code with column one code |
1 |
87653 |
83912 |
Misuse of column two code with column one code |
1 |
87498 |
83908 |
Misuse of column two code with column one code |
|
87253 |
87498 |
Misuse of column two code with column one code |
1 |
87538 |
83913 |
More extensive procedure |
1 |
87517 |
83913 |
More extensive procedure |
1 |
87641 |
83891 |
Misuse of column two code with column one code |
1 |
87653 |
83891 |
Misuse of column two code with column one code |
1 |
87512 |
83913 |
More extensive procedure |
1 |
87651 |
83913 |
More extensive procedure |
1 |
87800 |
83913 |
More extensive procedure |
1 |
87470 |
83913 |
More extensive procedure |
1 |
0148T |
0145T |
More extensive procedure |
0 |
87561 |
83913 |
More extensive procedure |
1 |
87641 |
83897 |
Misuse of column two code with column one code |
1 |
87640 |
83890 |
Misuse of column two code with column one code |
1 |
87641 |
83909 |
Misuse of column two code with column one code |
1 |
87653 |
80502 |
Standards of medical / surgical practice |
1 |
87640 |
83898 |
Misuse of column two code with column one code |
1 |
87552 |
83913 |
More extensive procedure |
1 |
87653 |
80500 |
Standards of medical / surgical practice |
1 |
87498 |
83907 |
Misuse of column two code with column one code |
1 |
87149 |
87498 |
Misuse of column two code with column one code |
1 |
87640 |
83896 |
Misuse of column two code with column one code |
1 |
87641 |
83894 |
Misuse of column two code with column one code |
1 |
87498 |
83892 |
Misuse of column two code with column one code |
1 |
87498 |
83891 |
Misuse of column two code with column one code |
1 |
83950 |
83913 |
More extensive procedure |
1 |
87653 |
83892 |
Misuse of column two code with column one code |
1 |
0145T |
0147T |
Misuse of column two code with column one code |
0 |
87536 |
83913 |
More extensive procedure |
1 |
87640 |
83900 |
Misuse of column two code with column one code |
1 |
87903 |
83913 |
More extensive procedure |
1 |
87641 |
83907 |
Misuse of column two code with column one code |
1 |
87542 |
83913 |
More extensive procedure |
1 |
88309 |
89060 |
HCPCS/CPT coding manual instruction / guideline |
1 |
87592 |
83913 |
More extensive procedure |
1 |
87522 |
83913 |
More extensive procedure |
1 |
87590 |
83913 |
More extensive procedure |
1 |
87525 |
83913 |
More extensive procedure |
1 |
87653 |
83896 |
Misuse of column two code with column one code |
1 |
0148T |
0146T |
HCPCS/CPT procedure code definition |
0 |
87653 |
83913 |
More extensive procedure |
1 |
87498 |
83902 |
Misuse of column two code with column one code |
1 |
0147T |
0150T |
Misuse of column two code with column one code |
0 |
87498 |
83901 |
Misuse of column two code with column one code |
1 |
87640 |
83893 |
Misuse of column two code with column one code |
1 |
87798 |
83913 |
More extensive procedure |
1 |
87527 |
83913 |
More extensive procedure |
1 |
0145T |
0144T |
HCPCS/CPT coding manual instruction / guideline |
0 |
87521 |
83913 |
More extensive procedure |
1 |
87498 |
83913 |
More extensive procedure |
1 |
87901 |
83913 |
More extensive procedure |
1 |
0148T |
0144T |
HCPCS/CPT coding manual instruction / guideline |
0 |
0149T |
0150T |
Misuse of column two code with column one code |
0 |
87653 |
83908 |
Misuse of column two code with column one code |
1 |
87640 |
83891 |
Misuse of column two code with column one code |
1 |
87485 |
83913 |
More extensive procedure |
1 |
87498 |
80500 |
Standards of medical / surgical practice |
1 |
83913 |
80500 |
Standards of medical / surgical practice |
1 |
87556 |
83913 |
More extensive procedure |
1 |
87557 |
83913 |
More extensive procedure |
1 |
87641 |
83896 |
Misuse of column two code with column one code |
1 |
87621 |
83913 |
More extensive procedure |
1 |
87641 |
83900 |
Misuse of column two code with column one code |
1 |
87641 |
80502 |
Standards of medical / surgical practice |
1 |
87528 |
83913 |
More extensive procedure |
1 |
87620 |
83913 |
More extensive procedure |
1 |
87622 |
83913 |
More extensive procedure |
1 |
87539 |
83913 |
More extensive procedure |
1 |
0154T |
0153T |
HCPCS/CPT coding manual instruction / guideline |
1 |
87652 |
83913 |
More extensive procedure |
1 |
87653 |
83909 |
Misuse of column two code with column one code |
0 |
0149T |
0146T |
Misuse of column two code with column one code |
1 |
87902 |
83913 |
More extensive procedure |
1 |
87495 |
83913 |
More extensive procedure |
1 |
87808 |
80500 |
Standards of medical / surgical practice |
1 |
87650 |
83913 |
More extensive procedure |
1 |
87555 |
83913 |
More extensive procedure |
1 |
87641 |
83890 |
Misuse of column two code with column one code |
1 |
87640 |
83907 |
Misuse of column two code with column one code |
1 |
0148T |
0147T |
Misuse of column two code with column one code |
0 |
87653 |
83907 |
Misuse of column two code with column one code |
1 |
87641 |
83908 |
Misuse of column two code with column one code |
1 |
0148T |
0150T |
Misuse of column two code with column one code |
0 |
0149T |
0148T |
More extensive procedure |
0 |
87496 |
83913 |
More extensive procedure |
1 |
87640 |
83901 |
Misuse of column two code with column one code |
1 |
87640 |
80500 |
Standards of medical / surgical practice |
1 |
0147T |
0144T |
HCPCS/CPT coding manual instruction / guideline |
0 |
87641 |
80500 |
Standards of medical / surgical practice |
1 |
87533 |
83913 |
More extensive procedure |
1 |
87491 |
83913 |
More extensive procedure |
1 |
87641 |
83913 |
More extensive procedure |
1 |
87653 |
83898 |
Misuse of column two code with column one code |
1 |
87481 |
83913 |
More extensive procedure |
1 |
87531 |
83913 |
More extensive procedure |
1 |
0145T |
0146T |
Misuse of column two code with column one code |
0 |
87641 |
83902 |
More extensive procedure |
1 |
87487 |
83913 |
Misuse of column two code with column one code |
1 |
87640 |
83897 |
More extensive procedure |
1 |
87534 |
83913 |
Misuse of column two code with column one code |
1 |
87498 |
83900 |
More extensive procedure |
1 |
87149 |
83913 |
Misuse of column two code with column one code |
1 |
87591 |
83913 |
More extensive procedure |
1 |
88307 |
89060 |
HCPCS/CPT coding manual instruction / guideline |
1 |
87498 |
83909 |
Misuse of column two code with column one code |
1 |
87540 |
83913 |
More extensive procedure |
1 |
87541 |
83913 |
More extensive procedure |
1 |
87498 |
83898 |
Misuse of column two code with column one code |
1 |
87582 |
83913 |
More extensive procedure |
1 |
88304 |
89060 |
HCPCS/CPT coding manual instruction / guideline |
1 |
0149T |
0144T |
HCPCS/CPT coding manual instruction / guideline |
0 |
87551 |
83913 |
More extensive procedure |
1 |
87640 |
83913 |
More extensive procedure |
1 |
87498 |
83897 |
More extensive procedure |
1 |
87532 |
83913 |
Misuse of column two code with column one code |
1 |
87530 |
83913 |
More extensive procedure |
1 |
87640 |
83912 |
More extensive procedure |
1 |
87477 |
83913 |
More extensive procedure |
1 |
87641 |
83901 |
Misuse of column two code with column one code |
1 |
87511 |
83913 |
More extensive procedure |
1 |
87482 |
83913 |
More extensive procedure |
1 |
87560 |
83913 |
More extensive procedure |
1 |
0147T |
0146T |
More extensive procedure |
0 |
87475 |
83913 |
More extensive procedure |
|
87537 |
83913 |
More extensive procedure |
1 |
87797 |
83913 |
More extensive procedure |
1 |
87471 |
83913 |
More extensive procedure |
1 |
87516 |
83913 |
More extensive procedure |
1 |
87640 |
83894 |
Misuse of column two code with column one code |
1 |
87653 |
83901 |
Misuse of column two code with column one code |
1 |
87653 |
83897 |
Misuse of column two code with column one code |
1 |
87476 |
83913 |
More extensive procedure |
1 |
87480 |
83913 |
More extensive procedure |
1 |
87498 |
83893 |
Misuse of column two code with column one code |
1 |
88302 |
89060 |
HCPCS/CPT coding manual instruction / guideline |
1 |
87640 |
80502 |
Standards of medical / surgical practice |
1 |
0149T |
0147T |
HCPCS/CPT procedure code definition |
0 |
87641 |
83912 |
Misuse of column two code with column one code |
1 |
87641 |
87640 |
More extensive procedure |
1 |
87640 |
83909 |
Misuse of column two code with column one code |
1 |
87497 |
83913 |
More extensive procedure |
1 |
87653 |
83893 |
Misuse of column two code with column one code |
1 |
87653 |
83894 |
Misuse of column two code with column one code |
1 |
87498 |
83890 |
Misuse of column two code with column one code |
1 |
87653 |
83900 |
Misuse of column two code with column one code |
1 |
87801 |
87640 |
Misuse of column two code with column one code |
1 |
87515 |
83913 |
More extensive procedure |
1 |
87653 |
83890 |
Misuse of column two code with column one code |
1 |
0150T |
0144T |
HCPCS/CPT coding manual instruction / guideline |
0 |
87799 |
83913 |
More extensive procedure |
1 |
87149 |
87640 |
Misuse of column two code with column one code |
1 |
87641 |
83898 |
Misuse of column two code with column one code |
1 |
87640 |
83902 |
Misuse of column two code with column one code |
1 |
87640 |
83908 |
Misuse of column two code with column one code |
1 |
87580 |
83913 |
More extensive procedure |
1 |
87526 |
83913 |
More extensive procedure |
1 |
87535 |
83913 |
More extensive procedure |
1 |
0146T |
0144T |
HCPCS/CPT coding manual instruction / guideline |
0 |
87660 |
83913 |
More extensive procedure |
1 |
87498 |
80502 |
Standards of medical / surgical practice |
1 |
87520 |
83913 |
More extensive procedure |
1 |
87641 |
83892 |
Misuse of column two code with column one code |
1 |
87808 |
80502 |
Standards of medical / surgical practice |
1 |
87801 |
83913 |
More extensive procedure |
1 |