Term | Definition |
A Codes | Transportation codes (A0021-A0999), medical and surgical supplies (A4206-A8004), and administrative, miscellaneous and investigational services, equipment, and supplies (A9150-A9999) |
B Codes | Enteral and parenteral therapy (B4000-B9999) |
C Codes | Temporary codes for use with Outpatient Prospective Payment System (OPPS) (pass through) (C1300-C9899) |
E Codes | Durable Medical Equipment (E0100-E8002) |
G Codes | Procedures /professional services (temporary) (G0008-G9156) |
H Codes | Temporary national codes for governmental entities other than Medicare (H0001-H2037) |
J Codes | Drugs administered other than oral method (J0120-J8499) and Chemotherapy drugs (J8501-J9999) |
K Codes | Assigned to DME MAC (K0000-K0899) |
L Codes | Orthotic procedures and devices (L0000-L4999) and prosthetic procedures (L5000-L9900) |
M Codes | Medical Services (M0000-M0301) |
P Codes | Pathology and Laboratory Services (P0000-P9999) |
Q Codes | Procedures, Services, and supplies on a temporary basis (Q0035-Q9968) |
R Codes | Diagnostic radiology services (R0000-R9999) |
S Codes | Temporarily national codes (non Medicare) (S0000-S9999) |
T Codes | National codes established for state Medicaid agencies (T1000-T9999) |
V Codes | Vision Services (V0000-V2999) and hearing, which also includes speech-language pathology service (V5000-V5999) |
IA | Intra-arterial Administration - Administration of the drug is given within an artery. |
IV | Intravenous administration - Administration of the drug is given into the vein. |
IM | Intramuscular administration - Administration of the drug via an injection into a muscle. |
IT | Intrathecal - Administration of the drug is given into the subdural space of the spinal cord. |
SC | Subcutaneous administration - Administration of the drug via an injection just under the skin. |
INH | Administration by inhaled solution - Administration of the drug by breathing it. |
VAR | Various routes of administration - Administration of the drug by various routes commonly administered into joints, cavities, tissues, or topical applications |
OTH | Other routes of administration - other administration methods like suppositories or catheter injections. |
ORAL | Administered orally - Administration of the drug via taking it by mouth. |
Medicare Carriers Manual (MCM) References | Includes the Coverage Issue Manual (CIM) references, the Medicare Carriers Manual references contain CMS regulations and rulings concerning coverage procedures, services, and supplies. |
Medicare Statutes | The appendix covers statutory coverage issues (eg, 1862 [42 U.S.C. 1395y] (a)(1)(A)-(21), Exclusions from coverage and Medicare as Secondary Payer). |
E1 | Upper left, eyelid |
F5 | Right hand, thumb |
ET | Emergency services |
GM | Multiple patients on one ambulance trip |
HF | Substance abuse program |
RC | Right coronary artery |
Q6 | Service furnished by a locum tenens physician |
D | Diagnostic or therapeutic site other then "P" or "H" when these codes are used as origin codes |
E | Residential, domiciliary, custodial facility (other than an 1819 facility) |
G | Hospital-based ESRD facility (hospital or hospital related) |
H | Hospital |
I | Site of transfer (eg. airport or helicopter pad between modes of ambulance transport) |
J | Freestanding ESRD facility |
N | Skilled nursing facility (SNF) (1819 facility) |
P | Physician's office |
R | Residence |
S | Scene of accident or acute event |
X | (Destination code only) Intermediate stop at physician's office on the way to the hospital. |
HH | Ambulance trip from discharge/transfer from one hospital to another hospital |
RH | Ambulance trip from the patient's residence to a hospital |
SH | Ambulance trip from scene of accident to a hospital |
RP | Ambulance trip from the patient's residence to a physician's office |
Transportation Services including Ambulance For Ground | Basic life support (BLS); Advanced life support, Level 1 (ALS1); Advanced life support, Level 2 (ALS2); Specialty care transport (SCT); Paramedic ALS intercept (P1) |
Transportation Services including Ambulance For AIR | Fixed wing air ambulance (FW); Rotary wing air ambulance (RW) |
A0422 | Ambulance (ALS or BLS) oxygen and oxygen supplies, life-sustaining situation. |
A0433 | Advanced life support, level 2 (ALS2) |
A0434 | Specialty care transport (SCT) |
22 | Increased Procedural Service |
23 | Unusual Anesthesia |
24 | Unrelated E/M by the same Physician or Other qualified healthcare professional during a postoperative period |
25 | Significant, Separately Identifiable E/M service by the same Physician or Other Qualified Healthcare Professional on the same date of the procedure or other service. |
26 | Professional Component |
32 | Mandated Service |
47 | Anesthesia by Surgeon |
50 | Bilateral Procedure |
51 | Multiple Procedures |
52 | Reduced Services |
53 | Discontinued Procedure |
54 | Surgical Care Only |
55 | Postoperative Management only |
56 | Preoperative Management Only |
57 | Decision for Surgery |
58 | Staged or related procedure or service by the same physician or other qualified healthcare professional during the postoperative period. |
59 | Dental Procedural Service |
62 | Two Surgeons |
63 | Procedure performed on Infants less than 4 kg |
66 | Surgical Team |
76 | Repeat procedure or service by same Physician or Other qualified healthcare professional |
77 | Repeat procedure by Another Physician or Other Qualified Healthcare Professional. |
78 | Unplanned Return to the Operating/Procedure Room by the Same Physician or Other Qualified Healthcare Professional Following Initial Procedure for a Related Procedure During the Postoperative period. |
79 | Unrelated Procedure/Service by the Same Physician or Other qualified healthcare professional during the postoperative period |
80 | Assistant Surgeon |
81 | Minimum Assistant Surgeon |
82 | Assistant Surgeon (when qualified resident surgeon not available) |
90 | Reference (Outside) Labratory |
91 | Repeat Clinical Diagnostic Laboratory Test |
92 | Alternative Laboratory Platform Testing |
99 | Multiple Modifiers |
BO | Orally Administered Nutrition, Not by feeding tube |
E2 | Lower Left Eyelid |
F1 | Left Hand, Second Digit |
GA | Waiver of Liability Statement Issued as a Required by Payer, Policy, Individual Case |
GU | Waiver of Liability Statement Issued as a Required by Payer Policy, Routine Notice |
LT | Left Side |
NU | New Equipment |
Q6 | Service Furnished by a Locum Tenens Physician |
TC | Technical Component |