Current Procedural Terminology CPT Update (ACPT) · 2017-01-06 · Current Procedural Terminology CPT Update (ACPT) Version 2.17 Installation Guide and Release Notes Installation

RESOURCE AND PATIENT MANAGEMENT SYSTEM

Office of Information Technology (OIT) Division of Information Technology

Current Procedural Terminology CPT Update

(ACPT)

Installation Guide and Release Notes

Version 2.17 January 2017

Current Procedural Terminology CPT Update (ACPT) Version 2.17

Installation Guide and Release Notes Table of Contents January 2017

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Table of Contents

1.0 Release Notes ..................................................................................................... 1 1.1 General Information ................................................................................. 1

2.0 Installation Notes ................................................................................................ 2 2.1 Contents of Distribution ........................................................................... 2 2.2 Required Resources ................................................................................ 2

3.0 Installation Instructions ..................................................................................... 4

4.0 Sample Installation ............................................................................................. 5 4.1 Sample Installation 1 ............................................................................... 5 4.2 Sample Installation 2 ............................................................................... 6

5.0 Installation Configuration ................................................................................ 10

Glossary ....................................................................................................................... 37

Acronym List ............................................................................................................... 38

Contact Information .................................................................................................... 39


Installation Guide and Release Notes Preface January 2017

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Preface

This manual contains the installation guide for the IHS CPT Update, Version 2017 (ACPT 2.17).


Installation Guide and Release Notes Release Notes January 2017

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1.0 Release Notes Note: Read the entire notes files prior to attempting any

installation.

1.1 General Information • This release contains the annual CPT/HCPCS code updates for FY/CY 2017.

• As part of the annual update, this release will run the following cleanup utilities before updating the CPT codes:

− Inactivate CPT codes that were formerly improperly inactivated • The CPT Category file has been updated for 2017. This includes updates to

existing ranges.

• Following the category update, the 2017 CPT and Modifier code sets for both CPT and HCPCS will be installed (previously these were released separately). This will allow subsequent patch releases to this version to only contain quarterly updates.

• As part of the annual update, this release will run the following consistency reports after updating the CPT codes:

− Active, duplicate CPT/HCPCS codes • This report will display CPT/HCPCS codes present in the local system

which contain active duplicates

• Only one active entry should exist for a code, which assists with data consistency and integrity

• Sites may choose to manually inactivate any duplicates - we recommend that the most recently updated entry be left active

− Active CPT/HCPCS codes not found in the annual code set • This report will display CPT/HCPCS codes present in the local system

that are active but do not exist in the annual code set

• Common examples of entries in this report include locally added CPT codes (which are not part of the standard release) and improperly inactivated CPT codes (missed patch/inactivation or local modification)

• Sites may choose to manually inactivate any "invalid" codes on this list - Example: 94725 was inactivated 1/1/12 but remains active on the local system

• As part of the CPT Category update, this release will scan the CPT file and update the Category assignments as needed.


Installation Guide and Release Notes Installation Notes January 2017

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2.0 Installation Notes Prefix: ACPT Current Version: 2.17

2.1 Contents of Distribution Table 2-1: Contents of Distribution

File Description

acpt2017.k KIDS file

acpt2017.b 2017 CPT Global KIDS file

acpt2017i.pdf Installation Guide

2.2 Required Resources • Kernel v8 or later

• Kernel Toolkit v7.3 or later

• FileMan v22 or later

• ACPT 2.16 Patch 2 or later

• BCSV 1.0 Patch 3 or later

Applicable FARS/DFARS Restrictions Apply to Government Use.

U.S. Government Rights

CPT is commercial technical data and/or computer data bases and/or commercial computer software and/or commercial computer software documentation, as applicable, which were developed exclusively at private expense by the American Medical Association, 330 N. Wabash Ave., Suite 39300, Chicago, IL 60611-5885. U.S. Government rights to use, modify, reproduce, release, perform, display, or


Installation Guide and Release Notes Installation Notes January 2017

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disclose these technical data and/or computer data bases and/or computer software and/or computer software documentation are subject to the limited rights restrictions of DFARS 252.227-7015 (b) (2) (November 1995) and/or subject to the restrictions of DFARS 227.7202-1 (a) (June 1995) and DFARS 227.7202-3 (a) (June 1995), as applicable for U.S. Department of Defense procurements and the limited rights restrictions of FAR 52.227-14 (June 1987) and/or subject to the restricted rights provisions of FAR 52.227-14 (June 1987) and FAR 52.227-19 (June 1987), as applicable, and any applicable agency FAR Supplements, for non-Department of Defense Federal procurements.


Installation Guide and Release Notes Installation Instructions January 2017

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3.0 Installation Instructions 1. Run D ^%GOGEN, saving the following GLOBALS:

a. ÎCPT CPT

b. ^DIC(81.1 CPT CATEGORY

c. ^DIC(81.3 CPT MODIFIER

2. This release should be installed during off-peak hours.

3. Load the Global Distribution into the Kernel Installation and Distribution System (KIDS), using option 1 on the Installation menu. The distribution was released in a file named acpt2017.b.

4. Load the KIDS Distribution into KIDS using option 1 on the Installation menu. The distribution was released in a file named acpt2017.k.

5. Verify the load using option 2 on the Installation menu.

6. Use options 3 and 4 to print and compare the Transport.

7. Install the distribution using option 6 on the Installation menu.

8. For results, use the KIDS "Install File Print" option to view/print the "ACPT 2.17" entry.


Installation Guide and Release Notes Sample Installation January 2017

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4.0 Sample Installation Figure 4-1 and Figure 4-2 shows a sample installation. Screens may not be exactly the same during installation. Note that a message saying “Couldn’t find code to inactivate” will display when deleting codes and the code is not found.

4.1 Sample Installation 1 acpt2017.b

D ^XUP Setting up programmer environment This is a PRODUCTION account. Terminal Type set to: C-VT100 Select OPTION NAME: XPD MAIN Kernel Installation & Distribution System Edits and Distribution ... Utilities ... Installation ... Patch Monitor Main Menu ... Select Kernel Installation & Distribution System Option: INstallation 1 Load a Distribution 2 Verify Checksums in Transport Global 3 Print Transport Global 4 Compare Transport Global to Current System 5 Backup a Transport Global 6 Install Package(s) Restart Install of Package(s) Unload a Distribution Select Installation Option: 1 Load a Distribution Enter a Host File: C:\Patches\ACPT 2.17\acpt2017.b KIDS Distribution saved on Dec 16, 2016@13:26 Comment: FY/CY2017 Transport Global This Distribution contains Transport Globals for the following Package(s): ACPT GLOBAL 2.17 Distribution OK! This is a Global Distribution. It contains Global(s) that will update your system at this time. The following Global(s) will be installed: ÂCPT Replace **WARNING - Global will be KILLED before install, Check global protection on ALL systems before continuing. If you continue with the Load, the Global(s) will be Installed at this time.



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Want to Continue with Load? YES// Loading Distribution... ACPT GLOBAL 2.17 Globals will now be installed, OK? YES// Install Started for ACPT GLOBAL 2.17 : Dec 16, 2016@14:13:23 Installing Globals: ÂCPT Dec 16, 2016@14:13:23 Updating KIDS files... No link to PACKAGE file NO Install Message sent to FORUM ACPT GLOBAL 2.17 Installed. Dec 16, 2016@14:13:23

Figure 4-1: Installing ACPT Global (sample installation)

4.2 Sample Installation 2 acpt2017.k

D ^XUP Setting up programmer environment This is a PRODUCTION account. Terminal Type set to: C-VT100 Select OPTION NAME: XPD MAIN Kernel Installation & Distribution System Edits and Distribution ... Utilities ... Installation ... Patch Monitor Main Menu ... Select Kernel Installation & Distribution System Option: INstallation 1 Load a Distribution 2 Verify Checksums in Transport Global 3 Print Transport Global 4 Compare Transport Global to Current System 5 Backup a Transport Global 6 Install Package(s) Restart Install of Package(s) Unload a Distribution



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Select Installation Option: 1 Load a Distribution Enter a Host File: C:\Patches\ACPT 2.17\acpt2017.k KIDS Distribution saved on Dec 16, 2016@13:26:21 Comment: FY/CY2017 CPT/HCPCS Code Update This Distribution contains Transport Globals for the following Package(s): ACPT 2.17 Distribution OK! Want to Continue with Load? YES// Loading Distribution... Build ACPT 2.17 has an Environmental Check Routine Want to RUN the Environment Check Routine? YES// ACPT 2.17 Will first run the Environment Check Routine, ACPT217 Hello, SYSTEM MANAGER Checking Environment for CPT FILES V 2.17. Need at least XU v8.0.....XU v8.0 Present Need at least DI v22.0.....DI v22.0 Present Need at least XT v7.3.....XT v7.3 Present Need at least ACPT v2.16 p2.....ACPT v2.16 p2 Present Need at least BCSV v1.0 p3.....BCSV v1.0 p3 Present Need at least ACPT GLOBAL 2.17.....ACPT GLOBAL 2.17 Present ENVIRONMENT OK. Use INSTALL NAME: ACPT 2.17 to install this Distribution. 1 Load a Distribution 2 Verify Checksums in Transport Global 3 Print Transport Global 4 Compare Transport Global to Current System 5 Backup a Transport Global 6 Install Package(s) Restart Install of Package(s) Unload a Distribution Select Installation Option: 6 Install Package(s) Select INSTALL NAME: ACPT 2.178 Loaded from Distribution 12/16/16@14:13: 35 => FY/CY2017 CPT/HCPCS Code Update ;Created on Dec 16, 2016@13:26:21 This Distribution was loaded on Dec 16, 2016@14:13:35 with header of FY/CY2017 CPT/HCPCS Code Update ;Created on Dec 16, 2016@13:26:21 It consisted of the following Install(s): ACPT 2.17 Checking Install for Package ACPT 2.17 Will first run the Environment Check Routine, ACPT217 Hello, SYSTEM MANAGER Checking Environment for CPT FILES V 2.17.



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Need at least XU v8.0.....XU v8.0 Present Need at least DI v22.0.....DI v22.0 Present Need at least XT v7.3.....XT v7.3 Present Need at least ACPT v2.16 p2.....ACPT v2.16 p2 Present Need at least BCSV v1.0 p3.....BCSV v1.0 p3 Present Need at least ACPT GLOBAL 2.17.....ACPT GLOBAL 2.17 Present ENVIRONMENT OK. Install Questions for ACPT 2.17 Want KIDS to INHIBIT LOGONs during the install? YES// NO Want to DISABLE Scheduled Options, Menu Options, and Protocols? NO// Enter the Device you want to print the Install messages. You can queue the install by enter a 'Q' at the device prompt. Enter a '^' to abort the install. DEVICE: HOME// Virtual ACPT 2.17 Install Started for ACPT 2.17 : Dec 16, 2016@14:13:50 Build Distribution Date: Dec 16, 2016 Installing Routines: Dec 16, 2016@14:13:50 Running Pre-Install Routine: PREÂCPT217 ----- Fixing improperly inactivated CPT codes Running Post-Install Routine: POSTÂCPT217 165 CPT/HCPCS Categories: NAME NEW TYP SRC BEGIN END ==== === === === ===== ===== 112 CPT New Codes: CODE SHORT DESCRIPTION NEW STATUS SHORT LONG CAT EFFECTIVE ==== ================= === ====== ===== ==== === ========= 9957 CPT Updated Codes: CODE SHORT DESCRIPTION NEW STATUS SHORT LONG CAT EFFECTIVE ==== ================= === ====== ===== ==== === ========= 80 CPT Inactive Codes: CODE SHORT DESCRIPTION NEW STATUS SHORT LONG CAT EFFECTIVE ==== ================= === ====== ===== ==== === ========= 36 CPT Modifier Codes: CODE SHORT DESCRIPTION NEW STATUS SHORT LONG EFFECTIVE ==== ================= === ====== ===== ==== ========= 259 HCPCS New Codes: CODE SHORT DESCRIPTION NEW STATUS SHORT LONG CAT EFFECTIVE ==== ================= === ====== ===== ==== === =========



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5372 HCPCS Updated Codes: CODE SHORT DESCRIPTION NEW STATUS SHORT LONG CAT EFFECTIVE ==== ================= === ====== ===== ==== === ========= 526 HCPCS Inactive Codes: CODE SHORT DESCRIPTION NEW STATUS SHORT LONG CAT EFFECTIVE ==== ================= === ====== ===== ==== === ========= 343 HCPCS Modifier Codes: CODE SHORT DESCRIPTION NEW STATUS SHORT LONG EFFECTIVE ==== ================= === ====== ===== ==== ========= ----- Annual consistency reports ----- ----- Duplicate Report: Active duplicate CPT/HCPCS codes ----- CPT Report: Active CPT entries not found in annual code set ----- HCPCS Report: Active HCPCS entries not found in annual code set ----- Checking CPT codes for updated category assignments....... TOTAL CODES SCANNED: 24484 UPDATED: 0 (ALL ARE CURRENT) ASSIGNMENT CATEGORY (MAJOR): 1829 (SUB): 22557 Updating Routine file Updating KIDS files... ACPT 2.17 Installed. Dec 16, 2016@14:15:01 NO Install Message sent Install Completed

Figure 4-2: Installing ACPT KIDS (sample installation)


Installation Guide and Release Notes Installation Configuration January 2017

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5.0 Installation Configuration This is an update of CPT and HCPCS codes/modifiers/categories for the fiscal year/calendar year 2017. There is an additional requirement of BCSV.


Installation Guide and Release Notes Appendix A: 2017 HCP/HCPCS Categories January 2017

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Appendix A: 2017 HCP/HCPCS Categories NAME TYPE SRC BEGIN END ANESTHESIA Major CPT 00100 01999

ANESTHESIA FOR PROCEDURES ON THE HEAD Sub CPT 00100 00222

ANESTHESIA FOR PROCEDURES ON THE NECK Sub CPT 00300 00352

ANESTHESIA FOR PROCEDURES ON THE THORAX (CHEST WALL AND SHOULDER GIRDLE)

Sub CPT 00400 00474

ANESTHESIA FOR INTRATHORACIC PROCEDURES Sub CPT 00500 00580

ANESTHESIA FOR PROCEDURES ON THE SPINE AND SPINAL CORD

Sub CPT 00600 00670

ANESTHESIA FOR PROCEDURES ON THE UPPER ABDOMEN

Sub CPT 00700 00797

ANESTHESIA FOR PROCEDURES ON THE LOWER ABDOMEN

Sub CPT 00800 00882

ANESTHESIA FOR PROCEDURES ON THE PERINEUM Sub CPT 00902 00952

ANESTHESIA FOR PROCEDURES ON THE PELVIS (EXCEPT HIP)

Sub CPT 01112 01190

ANESTHESIA FOR PROCEDURES ON THE UPPER LEG (EXCEPT KNEE)

Sub CPT 01200 01274

ANESTHESIA FOR PROCEDURES ON THE KNEE AND POPLITEAL AREA

Sub CPT 01320 01444

ANESTHESIA FOR PROCEDURES ON THE LOWER LEG (BELOW KNEE)

Sub CPT 01462 01522

ANESTHESIA FOR PROCEDURES ON THE SHOULDER AND AXILLA

Sub CPT 01610 01682

ANESTHESIA FOR PROCEDURES ON THE UPPER ARM AND ELBOW

Sub CPT 01710 01782

ANESTHESIA FOR PROCEDURES ON THE FOREARM, WRIST, AND HAND

Sub CPT 01810 01860

ANESTHESIA FOR RADIOLOGICAL PROCEDURES Sub CPT 01916 01936

ANESTHESIA FOR BURN EXCISIONS OR DEBRIDEMENT PROCEDURES

Sub CPT 01951 01953

ANESTHESIA FOR OBSTETRIC PROCEDURES Sub CPT 01958 01969

ANESTHESIA FOR OTHER PROCEDURES Sub CPT 01990 01999

SURGERY Major CPT 10021 69990

FINE NEEDLE ASPIRATION SURGICAL PROCEDURES Sub CPT 10021 10022

SURGICAL PROCEDURES ON THE INTEGUMENTARY SYSTEM

Sub CPT 10030 19499



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NAME TYPE SRC BEGIN END SURGICAL PROCEDURES ON THE MUSCULOSKELETAL SYSTEM

Sub CPT 20005 29999

SURGICAL PROCEDURES ON THE RESPIRATORY SYSTEM

Sub CPT 30000 32999

SURGICAL PROCEDURES ON THE CARDIOVASCULAR SYSTEM

Sub CPT 33010 37799

SURGICAL PROCEDURES ON THE HEMIC AND LYMPHATIC SYSTEMS

Sub CPT 38100 38999

SURGICAL PROCEDURES ON THE MEDIASTINUM AND DIAPHRAGM

Sub CPT 39000 39599

SURGICAL PROCEDURES ON THE DIGESTIVE SYSTEM Sub CPT 40490 49999

SURGICAL PROCEDURES ON THE URINARY SYSTEM Sub CPT 50010 53899

SURGICAL PROCEDURES ON THE MALE GENITAL SYSTEM

Sub CPT 54000 55899

REPRODUCTIVE SYSTEM PROCEDURES Sub CPT 55920 55920

INTERSEX SURGERY Sub CPT 55970 55980

SURGICAL PROCEDURES ON THE FEMALE GENITAL SYSTEM

Sub CPT 56405 58999

SURGICAL PROCEDURES FOR MATERNITY CARE AND DELIVERY

Sub CPT 59000 59899

SURGICAL PROCEDURES ON THE ENDOCRINE SYSTEM Sub CPT 60000 60699

SURGICAL PROCEDURES ON THE NERVOUS SYSTEM Sub CPT 61000 64999

SURGICAL PROCEDURES ON THE EYE AND OCULAR ADNEXA

Sub CPT 65091 68899

SURGICAL PROCEDURES ON THE AUDITORY SYSTEM Sub CPT 69000 69979

OPERATING MICROSCOPE PROCEDURES Sub CPT 69990 69990

RADIOLOGY PROCEDURES Major CPT 70010 79999

DIAGNOSTIC RADIOLOGY (DIAGNOSTIC IMAGING) PROCEDURES

Sub CPT 70010 76499

DIAGNOSTIC ULTRASOUND PROCEDURES Sub CPT 76506 76999

RADIOLOGIC GUIDANCE Sub CPT 77001 77022

BREAST, MAMMOGRAPHY Sub CPT 77051 77063

BONE/JOINT STUDIES Sub CPT 77071 77086

RADIATION ONCOLOGY TREATMENT Sub CPT 77261 77799

NUCLEAR MEDICINE PROCEDURES Sub CPT 78012 79999

PATHOLOGY AND LABORATORY PROCEDURES Major CPT 80047 89398

ORGAN OR DISEASE ORIENTED PANELS Sub CPT 80047 80076



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NAME TYPE SRC BEGIN END DRUG TESTING Sub

THERAPEUTIC DRUG ASSAYS Sub CPT 80150 80377

DRUG ASSAY PROCEDURES Sub CPT 80300 80377

EVOCATIVE/SUPPRESSION TESTING PROCEDURES Sub CPT 80400 80439

CLINICAL PATHOLOGY CONSULTATIONS Sub CPT 80500 80502

URINALYSIS PROCEDURES Sub CPT 81000 81099

MOLECULAR PATHOLOGY PROCEDURES Sub CPT 81161 81479

GENOMIC SEQUENCING PROCEDURES AND OTHER MOLECULAR MULTIANALYTE ASSAYS

Sub CPT 81410 81471

MULTIANALYTE ASSAYS WITH ALGORITHMIC ANALYSES Sub CPT 81500 81599

CHEMISTRY PROCEDURES Sub CPT 82000 84999

HEMATOLOGY AND COAGULATION PROCEDURES Sub CPT 85002 85999

IMMUNOLOGY PROCEDURES Sub CPT 86000 86849

TRANSFUSION MEDICINE PROCEDURES Sub CPT 86850 86999

MICROBIOLOGY PROCEDURES Sub CPT 87003 87999

ANATOMIC PATHOLOGY PROCEDURES Sub CPT 88000 88099

CYTOPATHOLOGY PROCEDURES Sub CPT 88104 88199

CYTOGENETIC STUDIES Sub CPT 88230 88299

SURGICAL PATHOLOGY PROCEDURES Sub CPT 88300 88399

IN VIVO (EG, TRANSCUTANEOUS) LABORATORY PROCEDURES

Sub CPT 88720 88749

OTHER PATHOLOGY AND LABORATORY PROCEDURES Sub CPT 89049 89240

REPRODUCTIVE MEDICINE PROCEDURES Sub CPT 89250 89398

MEDICINE SERVICES AND PROCEDURES Major CPT 90281 99607

IMMUNE GLOBULINS, SERUM OR RECOMBINANT PRODUCTS

Sub CPT 90281 90399

IMMUNIZATION ADMINISTRATION FOR VACCINES/TOXOIDS

Sub CPT 90460 90474

VACCINES, TOXOIDS (IMMUNIZATION) Sub CPT 90476 90749

PSYCHIATRY SERVICES AND PROCEDURES Sub CPT 90785 90899

BIOFEEDBACK SERVICES AND PROCEDURES Sub CPT 90901 90911

DIALYSIS SERVICES AND PROCEDURES Sub CPT 90935 90999

GASTROENTEROLOGY PROCEDURES Sub CPT 91010 91299

OPHTHALMOLOGY SERVICES AND PROCEDURES Sub CPT 92002 92499



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NAME TYPE SRC BEGIN END SPECIAL OTORHINOLARYNGOLOGIC SERVICES AND PROCEDURES

Sub CPT 92502 92700

CARDIOVASCULAR PROCEDURES Sub CPT 92920 93799

NON-INVASIVE VASCULAR DIAGNOSTIC STUDIES Sub CPT 93880 93998

PULMONARY PROCEDURES Sub CPT 94002 94799

ALLERGY AND CLINICAL IMMUNOLOGY PROCEDURES Sub CPT 95004 95199

ENDOCRINOLOGY SERVICES Sub CPT 95250 95251

NEUROLOGY AND NEUROMUSCULAR PROCEDURES Sub CPT 95782 96020

MEDICAL GENETICS AND GENETIC COUNSELING SERVICES

Sub CPT 96040 96040

CENTRAL NERVOUS SYSTEM ASSESSMENTS/TESTS (EG, NEURO-COG, MENT STAT, SPCH TSTING)

Sub CPT 96101 96127

HEALTH AND BEHAVIOR ASSESSMENT/INTERVENTION PROCEDURES

Sub CPT 96150 96155

HYD, THR, PRO, DIAG INJS/INFS, & CHEMO & OTH HIGHLY COMPLEX DRUG/BIO AGENT ADMN

Sub CPT 96360 96549

PHOTODYNAMIC THERAPY PROCEDURES Sub CPT 96567 96571

SPECIAL DERMATOLOGICAL PROCEDURES Sub CPT 96900 96999

PHYSICAL MEDICINE AND REHABILITATION EVALUATIONS

Sub CPT 97001 97799

MEDICAL NUTRITION THERAPY PROCEDURES Sub CPT 97802 97804

ACUPUNCTURE PROCEDURES Sub CPT 97810 97814

OSTEOPATHIC MANIPULATIVE TREATMENT PROCEDURES

Sub CPT 98925 98929

CHIROPRACTIC MANIPULATIVE TREATMENT PROCEDURES

Sub CPT 98940 98943

EDUCATION AND TRAINING FOR PATIENT SELF-MANAGEMENT

Sub CPT 98960 98962

NON-FACE-TO-FACE NONPHYSICIAN SERVICES Sub CPT 98966 98969

SPECIAL SERVICES, PROCEDURES AND REPORTS Sub CPT 99000 99091

QUALIFYING CIRCUMSTANCES FOR ANESTHESIA Sub CPT 99100 99140

MODERATE (CONSCIOUS) SEDATION Sub CPT 99143 99150

OTHER MEDICINE SERVICES AND PROCEDURES Sub CPT 99170 99199

HOME HEALTH PROCEDURES AND SERVICES Sub CPT 99500 99602

MEDICATION THERAPY MANAGEMENT SERVICES Sub CPT 99605 99607

EVALUATION AND MANAGEMENT SERVICES Major CPT 99201 99499

OFFICE OR OTHER OUTPATIENT SERVICES Sub CPT 99201 99215



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NAME TYPE SRC BEGIN END HOSPITAL OBSERVATION SERVICES Sub CPT 99217 99226

HOSPITAL INPATIENT SERVICES Sub CPT 99221 99239

CONSULTATION SERVICES Sub CPT 99241 99255

EMERGENCY DEPARTMENT SERVICES Sub CPT 99281 99288

CRITICAL CARE SERVICES Sub CPT 99291 99292

NURSING FACILITY SERVICES Sub CPT 99304 99318

DOMICILIARY, REST HOME (EG, BOARDING HOME), OR CUSTODIAL CARE SERVICES

Sub CPT 99324 99337

DOMICILIARY, REST HOME (EG, ASSISTED LIVING FCTY), HOME CARE PLAN OVERSIGHT SVCS

Sub CPT 99339 99340

HOME SERVICES Sub CPT 99341 99350

PROLONGED SERVICES Sub CPT 99354 99360

CASE MANAGEMENT SERVICES Sub CPT 99363 99368

CARE PLAN OVERSIGHT SERVICES Sub CPT 99374 99380

PREVENTIVE MEDICINE SERVICES Sub CPT 99381 99429

NON-FACE-TO-FACE SERVICES Sub CPT 99441 99449

SPECIAL EVALUATION AND MANAGEMENT SERVICES Sub CPT 99450 99456

NEWBORN CARE SERVICES Sub CPT 99460 99463

DELIVERY/BIRTHING ROOM ATTENDANCE AND RESUSCITATION SERVICES

Sub CPT 99464 99465

INPATIENT NEONATAL INTENSIVE CARE SVCS & PEDIATRIC & NEONATAL CRITICAL CARE SVCS

Sub CPT 99466 99486

CARE MANAGEMENT EVALUATION AND MANAGEMENT SERVICES

Sub CPT 99487 99490

TRANSITIONAL CARE EVALUATION AND MANAGEMENT SERVICES

Sub CPT 99495 99496

ADVANCE CARE PLANNING EVALUATION AND MANAGEMENT SERVICES

Sub CPT 99497 99498

OTHER EVALUATION AND MANAGEMENT SERVICES Sub CPT 99499 99499

CATEGORY II CODES Major CPT 0001F 9999F

COMPOSITE MEASURES Sub CPT 0001F 0015F

PATIENT MANAGEMENT Sub CPT 0500F 0584F

PATIENT HISTORY Sub CPT 1000F 1505F

PHYSICAL EXAMINATION Sub CPT 2000F 2060F

DIAGNOSTIC/SCREENING PROCESSES OR RESULTS Sub CPT 3001F 3999F

THERAPEUTIC, PREVENTIVE OR OTHER INTERVENTIONS

Sub CPT 4000F 4563F



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NAME TYPE SRC BEGIN END FOLLOW-UP OR OTHER OUTCOMES Sub CPT 5005F 5250F

PATIENT SAFETY Sub CPT 6005F 6150F

STRUCTURAL MEASURES Sub CPT 7010F 7025F

NON-MEASURE CLAIMS BASED REPORTING Sub CPT 9001F 9007F

MULTIANALYTE ASSAY Major CPT 0001M 0010M

CATEGORY III CODES Major CPT 0001T 9999T

HCPCS CODES Major HCPCS A0021 V5364

TRANSPORTATION SERVICES INCLUDING AMBULANCE Sub HCPCS A0021 A0999

MEDICAL AND SURGICAL SUPPLIES Sub HCPCS A4206 A8004

ADMINISTRATIVE, MISCELLANEOUS AND INVESTIGATIONAL

Sub HCPCS A9150 A9999

ENTERAL AND PARENTERAL THERAPY Sub HCPCS B4000 B9999

OUTPATIENT PPS Sub HCPCS C1300 C9899

DURABLE MEDICAL EQUIPMENT Sub HCPCS E0100 E9999

PROCEDURES / PROFESSIONAL SERVICES Sub HCPCS G0008 G9999

ALCOHOL AND DRUG ABUSE TREATMENT Sub HCPCS H0001 H9999

DRUGS ADMINISTERED OTHER THAN ORAL METHOD Sub HCPCS J0120 J8999

CHEMOTHERAPY DRUGS Sub HCPCS J9000 J9999

DURABLE MEDICAL EQUIPMENT (DME) MEDICARE ADMINISTRATIVE CONTRACTORS (MACS)

Sub HCPCS K0000 K9999

ORTHOTIC PROCEDURES AND SERVICES Sub HCPCS L0000 L4999

PROSTHETIC PROCEDURES Sub HCPCS L5000 L9999

MEDICAL SERVICES Sub HCPCS M0000 M0301

PATHOLOGY AND LABORATORY SERVICES Sub HCPCS P0000 P9999

TEMPORARY CODES Sub HCPCS Q0035 Q9999

DIAGNOSTIC RADIOLOGY SERVICES Sub HCPCS R0000 R5999

TEMPORARY NATIONAL CODES (NON-MEDICARE) Sub HCPCS S0000 S9999

NATIONAL CODES ESTABLISHED FOR STATE MEDICAID AGENCIES

Sub HCPCS T1000 T9999

VISION SERVICES Sub HCPCS V0000 V2999

HEARING SERVICES Sub HCPCS V5000 V5999


Installation Guide and Release Notes Appendix B: 2017 CPT/HCPCS New Codes January 2017

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Appendix B: 2017 CPT/HCPCS New CodesCODE SHORT DESCRIPTION 22853 INSJ BIOMECHANICAL DEVICE

22854 INSJ BIOMECHANICAL DEVICE

22859 INSJ BIOMECHANICAL DEVICE

22867 INSJ STABLJ DEV W/DCMPRN

22868 INSJ STABLJ DEV W/DCMPRN

22869 INSJ STABLJ DEV W/O DCMPRN

22870 INSJ STABLJ DEV W/O DCMPRN

27197 CLSD TX PELVIC RING FX

27198 CLSD TX PELVIC RING FX

28291 CORRJ HALUX RIGDUS W/IMPLT

28295 CORRECTION HALLUX VALGUS

31551 LARYNGOPLASTY LARYNGEAL STEN




31572 LARGSC W/LASER DSTRJ LES

31573 LARGSC W/THER INJECTION

31574 LARGSC W/NJX AUGMENTATION

31591 LARYNGOPLASTY MEDIALIZATION

31592 CRICOTRACHEAL RESECTION

33340 PERQ CLSR TCAT L ATR APNDGE

33390 VALVULOPLASTY AORTIC VALVE

33391 VALVULOPLASTY AORTIC VALVE

36456 PRTL EXCHANGE TRANSFUSE NB

36473 ENDOVENOUS MCHNCHEM 1ST VEIN

36474 ENDOVENOUS MCHNCHEM ADD-ON

36901 INTRO CATH DIALYSIS CIRCUIT

CODE SHORT DESCRIPTION 36902 INTRO CATH DIALYSIS CIRCUIT

36903 INTRO CATH DIALYSIS CIRCUIT

36904 THRMBC/NFS DIALYSIS CIRCUIT



36907 BALO ANGIOP CTR DIALYSIS SEG

36908 STENT PLMT CTR DIALYSIS SEG

36909 DIALYSIS CIRCUIT EMBOLJ

37246 TRLUML BALO ANGIOP 1ST ART

37247 TRLUML BALO ANGIOP ADDL ART

37248 TRLUML BALO ANGIOP 1ST VEIN

37249 TRLUML BALO ANGIOP ADDL VEIN

43284 LAPS ESOPHGL SPHNCTR AGMNTJ

43285 RMVL ESOPHGL SPHNCTR DEV

58674 LAPS ABLTJ UTERINE FIBROIDS

62320 NJX INTERLAMINAR CRV/THRC


62322 NJX INTERLAMINAR LMBR/SAC






62380 NDSC DCMPRN 1 NTRSPC LUMBAR

76706 US ABDL AORTA SCREEN AAA

77065 DX MAMMO INCL CAD UNI

77066 DX MAMMO INCL CAD BI

77067 SCR MAMMO BI INCL CAD

80305 DRUG TEST PRSMV DIR OPT OBS

80306 DRUG TEST PRSMV INSTRMNT



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CODE SHORT DESCRIPTION 80307 DRUG TEST PRSMV CHEM ANLYZR

81327 SEPT9 METHYLATION ANALYSIS

81413 CAR ION CHNNLPATH INC 10 GNS

81414 CAR ION CHNNLPATH INC 2 GNS

81422 FETAL CHRMOML MICRODELTJ

81439 INHERITED CARDMYPTHY 5 GNS

81539 ONCOLOGY PROSTATE PROB SCORE

84410 TESTOSTERONE BIOAVAILABLE

87483 CNS DNA AMP PROBE TYPE 12-25

90674 CCIIV4 VAC NO PRSV 0.5 ML IM

90682 IIV4 VACCINE SPLT 0.5 ML IM

90750 HZV VACC RECOMBINANT IM NJX

92242 FLUORESCEIN ICG ANGIOGRAPHY

93590 PERQ TRANSCATH CLS MITRAL

93591 PERQ TRANSCATH CLS AORTIC

93592 PERQ TRANSCATH CLOSURE EACH

96160 PT-FOCUSED HLTH RISK ASSMT

96161 CAREGIVER HEALTH RISK ASSMT

96377 APPLICATON ON-BODY INJECTOR

97161 PT EVAL LOW COMPLEX 20 MIN

97162 PT EVAL MOD COMPLEX 30 MIN

97163 PT EVAL HIGH COMPLEX 45 MIN

97164 PT RE-EVAL EST PLAN CARE

97165 OT EVAL LOW COMPLEX 30 MIN

97166 OT EVAL MOD COMPLEX 45 MIN

97167 OT EVAL HIGH COMPLEX 60 MIN

97168 OT RE-EVAL EST PLAN CARE

97169 ATHLETIC TRN EVAL LOW CMPLX

97170 ATHLETIC TRN EVAL MOD CMPLX

97171 ATHLETIC TRN EVAL HIGH CMPLX

97172 ATHLETIC TRN RE-EVAL PLAN CR

99151 MOD SED SAME PHYS/QHP <5 YRS

CODE SHORT DESCRIPTION 99152 MOD SED SAME PHYS/QHP 5/>YRS

99153 MOD SED SAME PHYS/QHP EA

99155 MOD SED OTH PHYS/QHP <5 YRS

99156 MOD SED OTH PHYS/QHP 5/>YRS

99157 MOD SED OTHER PHYS/QHP EA

0446T INSJ IMPLTBL GLUCOSE SENSOR

0447T RMVL IMPLTBL GLUCOSE SENSOR

0448T REMVL INSJ IMPLTBL GLUC SENS

0449T INSJ AQUEOUS DRAIN DEV 1ST

0450T INSJ AQUEOUS DRAIN DEV EACH

0451T INSJ/RPLCMT AORTIC VENTR SYS

0452T INSJ/RPLCMT DEV VASC SEAL

0453T INSJ/RPLCMT MECH-ELEC NTRFCE

0454T INSJ/RPLCMT SUBQ ELECTRODE

0455T REMVL AORTIC VENTR CMPL SYS

0456T REMVL AORTIC DEV VASC SEAL

0457T REMVL MECH-ELEC SKIN NTRFCE

0458T REMVL SUBQ ELECTRODE

0459T RELOCAJ RPLCMT AORTIC VENTR

0460T REPOS AORTIC VENTR DEV ELTRD

0461T REPOS AORTIC CONTRPULSJ DEV

0462T PRGRMG EVAL AORTIC VENTR SYS

0463T INTERROG AORTIC VENTR SYS

A4224 Supply insulin inf cath/wk

A4225 Sup/ext insulin inf pump syr

A4467 Belt strap sleev grmnt cover

A4553 Nondisp underpads, all sizes

A9285 Inversion eversion cor devic

A9286 Any hygienic item, device

A9515 Choline c-11

A9587 Gallium ga-68

A9588 Fluciclovine f-18

A9597 Pet, dx, for tumor id, noc



19

CODE SHORT DESCRIPTION A9598 Pet dx for non-tumor id, noc

C1889 Implant/insert device, noc

C9139 Idelvion, 1 i.u.

C9140 Afstyla factor viii recomb

C9481 Injection, reslizumab

C9482 Sotalol hydrochloride iv

C9483 Injection, atezolizumab

C9744 Abd us w/contrast

G0490 Home visit rn, lpn by rhc/fq

G0491 Dialysis acu kidney no esrd

G0492 Md/oth eval acut kid no esrd

G0493 Rn care ea 15 min hh/hospice

G0494 Lpn care ea 15min hh/hospice

G0495 Rn care train/edu in hh

G0496 Lpn care train/edu in hh

G0498 Chemo extend iv infus w/pump

G0499 Hepb screen high risk indiv

G0500 Mod sedat endo service >5yrs

G0501 Resource-inten svc during ov

G0502 Init psych care manag, 70min

G0503 Subseq psych care man,60mi

G0504 Init/sub psych care add 30 m

G0505 Cog/func assessment outpt

G0506 Comp asses care plan ccm svc

G0507 Care manage serv minimum 20

G0508 Crit care telehea consult 60

G0509 Crit care telehea consult 50

G9679 Acute care pneumonia

G9680 Acute care congestive heart

G9681 Acute care chronic obstruct

G9682 Acute care skin infection

G9683 Acute care fluid or electrol

G9684 Acute care urinary tract inf

CODE SHORT DESCRIPTION G9685 Acute nursing facility care

G9686 Nursing facility conference

G9687 Hospice anytime msmt per

G9688 Pt w/hosp anytime msmt per

G9689 Inpt elect carotid intervent

G9690 Pt rec hospice dur msmt per

G9691 Pt hosp dur msmt period

G9692 Hosp recd by pt dur msmt per

G9693 Pt use hosp during msmt per

G9694 Hosp srv used pt in msmt per

G9695 Long act inhal bronchdil pre

G9696 Med rsn no presc bronchdil

G9697 Pt rsn no presc bronchdil

G9698 Sys rsn no presc bronchdil

G9699 Long inhal bronchdil no pres

G9700 Pt is w/hosp during msmt per

G9701 Child anbx 30 prior dx estab


G9703 Child anbx 30 prior dx phary

G9704 Ajcc br ca stg i: t1 mic/t1a

G9705 Ajcc br ca stg ib

G9706 Low recur prost ca

G9707 Pt had hosp dur msmt per

G9708 Bilat mast/hx bi /unilat mas

G9709 Hosp srv used pt in msmt per

G9710 Pt prov hosp srv msmt per

G9711 Pt hx tot col or colon ca

G9712 Doc med rsn presc anbx


G9714 Pt is w/hosp during msmt per


G9716 Bmi not norm, no follow, doc

G9717 Doc dx depr/dx bipol, no scr



20

CODE SHORT DESCRIPTION G9718 Hospice anytime msmt per

G9719 Pt not ambul/immob/wc

G9720 Hospice anytime msmt per

G9721 Pt not ambul/immob/wc

G9722 Doc hx renal fail or cr+ >4

G9723 Hosp recd by pt dur msmt per

G9724 Pt w/doc use anticoag mst yr


G9726 Refused to participate

G9727 No knee intake prom, no prox


G9729 No hip intake prom, no proxy


G9731 No foot prom, no proxy


G9733 No back intake prom, no prox


G9735 Pt no foto knee and no proxy


G9737 Pt no foto elbow, no proxy


G9739 Pt no foto orth, no proxy

G9740 Hosp srv to pt dur msmt per


G9742 Psych sympt assessed

G9743 Psych symp not assessed, rns

G9744 Pt not elig, dx htn

G9745 Doc rsn no scr high bp

G9746 Mit sten, valve or trans af

G9747 Pall dialysis with catheter

G9748 App transpl lvg kidney donor

G9749 Pall dialysis with catheter

G9750 App transpl lvg kidney donor

CODE SHORT DESCRIPTION G9751 Pt died w/in 24 mos rpt time

G9752 Urgent surgery

G9753 Doc no dicom, ct other fac

G9754 Incid pulm nodule

G9755 Doc med rsn for imaging

G9756 Surg proc w/silicone oil

G9757 Surg proc w/silicone oil

G9758 Hospice or term phase

G9759 Hx preop post cap rup



G9762 Pt had hpv b/t 9-13 yr

G9763 Pt no hpv b/t 9-13 yr

G9764 Pt tx oral syst/bio med psor

G9765 Pt decl chan/conind or <6m

G9766 Cva stroke dx tx transf fac

G9767 Hosp new dx cva consid evst


G9769 Bn den 2yr/got ost med/ther

G9770 Perip nerve block

G9771 Anes end, 1 temp >35.5(95.9)

G9772 Doc temp >35.5(95.9), anest

G9773 No temp >35.5(95.9), anes

G9774 Pt had hyst

G9775 Recd 2 anti-emet pre/intraop

G9776 Doc med rsn no proph antiem

G9777 Pt no antiemet pre/intraop

G9778 Pts dx w/pregn

G9779 Pts breastfeeding

G9780 Pts dx w/rhabdomyolysis

G9781 Doc rsn no statin

G9782 Hx dx fam/pure hypercholes

G9783 Doc dx dm, fast <70, no stat



21

CODE SHORT DESCRIPTION G9784 Path/derm 2nd opin bx

G9785 Path rpt snt path/derm in 7d

G9786 No path rpt sent in 7d

G9787 Pt alive lst day msmt yr

G9788 Most rct bp </= 140/90

G9789 Record bp ip, er, urg/self

G9790 Most rct bp >/= 140/90

G9791 Most rct tob stat free

G9792 Most rct tob stat not free

G9793 Pt on daily asa/antiplat

G9794 Doc med rsn no asa/antiplat

G9795 Pt no daily asa/antiplat

G9796 Pt not currently on statin

G9797 Pt currently on statin

G9798 D/c ami btw 7/1-6/30 mst per

G9799 Med disp evt indic hx asth

G9800 Pt id intol/alleg beta-block

G9801 Nonacut transf from inpt


G9803 Post d/c 180d tx beta-bl ami

G9804 No post d/c 180d tx bb ami


G9806 Pt recd cerv cyto/hpv

G9807 Pt no recd cerv cyto/hpv

G9808 Pt no asthm cont med mst per


G9810 Pdc 75% w/asth cont med

G9811 No pdc 75% w/asth cont med

G9812 Pt died during inpt/30d aft

G9813 Pt not died w/in 30d of proc

G9814 Death occ dur hospitaliz

G9815 No death occ dur hospitaliz

G9816 Death occ 30d post proc

CODE SHORT DESCRIPTION G9817 No death occ 30d post proc

G9818 Doc sex activity


G9820 Doc chlam scr test w/follow

G9821 No doc chlam scr ts w/follow

G9822 Endo abl proc yr prev ind dt

G9823 Endo smpl/hyst bx res doc

G9824 Endo smpl/hyst bx res no doc

G9825 Her-2 neg,undoc/unkn

G9826 Transf pract aft init chemo

G9827 Her-2 targ ther no init tx

G9828 Her-2 targ ther dur init tx

G9829 Breast adj chemo admin

G9830 Her-2 pos

G9831 Ajcc stg brt ca dx ii or iii

G9832 Brt ca dx i, no t1/t1a/t1b

G9833 Transf pract aft init chemo

G9834 Pt met dis at dx

G9835 Trastuz given w/in 12 mos dx

G9836 Rsn no trast given doc

G9837 Trastuz not in 12 mos dx


G9839 Anti-egfr mon anti ther

G9840 Kras tst bfr beg anti moab

G9841 No kras tst bfr beg ant moab


G9843 Kras gene mut

G9844 Pt no recd anti-egfr ther

G9845 Pt recd anti-egfr ther

G9846 Pt died from cancer

G9847 Pt recd chemo last 14d life

G9848 Pt no chemo last 14d life




22

CODE SHORT DESCRIPTION G9850 1/more ed last 30d life

G9851 1/no ed visit last 30d life


G9853 Icu stay last 30d life

G9854 No icu stay last 30d life


G9856 Pt no hospice

G9857 Pt admit hospice

G9858 Pt enroll hospice


G9860 Pt less 3d hospice

G9861 Pt more than 3d hospice

G9862 Doc rsn no 10 yr follow

J0570 Buprenorphine implant 74.2mg

J0883 Argatroban nonesrd use 1mg

J0884 Argatroban esrd dialysis 1mg

J1130 Inj diclofenac sodium 0.5mg

J1942 Aripiprazole lauroxil 1mg

J2182 Injection, mepolizumab, 1mg

J2786 Injection, reslizumab, 1mg

J2840 Inj sebelipase alfa 1 mg

J7175 Inj, factor x, (human), 1iu

J7179 Vonvendi inj 1 iu vwf:rco

J7202 Factor ix idelvion inj

J7207 Factor viii pegylated recomb

J7209 Factor viii nuwiq recomb 1iu

CODE SHORT DESCRIPTION J7320 Genvisc 850, inj, 1mg

J7322 Hymovis injection 1 mg

J7342 Ciprofloxacin otic susp 6 mg

J8670 Rolapitant, oral, 1mg

J9034 Inj., bendeka 1 mg

J9145 Injection, daratumumab 10 mg

J9176 Injection, elotuzumab, 1mg

J9205 Inj irinotecan liposome 1 mg

J9295 Injection, necitumumab, 1 mg

J9325 Inj talimogene laherparepvec

J9352 Injection trabectedin 0.1mg

L1851 Ko single upright prefab ots

L1852 Ko double upright prefab ots

Q4166 Cytal, per square centimeter

Q4167 Truskin, per sq centimeter

Q4168 Amnioband, 1 mg

Q4169 Artacent wound, per sq cm

Q4170 Cygnus, per sq cm

Q4171 Interfyl, 1 mg

Q4172 Puraply or puraply am

Q4173 Palingen or palingen xplus

Q4174 Palingen or promatrx

Q4175 Miroderm

T1040 Comm bh clinic svc per diem

T1041 Comm bh clinic svc per month


Installation Guide and Release Notes Appendix C: 2017 CPT/HCPCS Modified Codes January 2017

23

Appendix C: 2017 CPT/HCPCS Modified Codes CODE SHORT DESCRIPTION SHORT LONG 11403 EXC TR-EXT B9+MARG 2.1-3CM/< S

11750 REMOVAL OF NAIL BED L

13122 CMPLX RPR S/A/L ADDL 5 CM/> S

19298 PLACE BREAST RAD TUBE/CATHS L

20240 BONE BIOPSY OPEN SUPERFICIAL S L

20245 BONE BIOPSY OPEN DEEP S L

28289 CORRJ HALUX RIGDUS W/O IMPLT S L

28292 CORRECTION HALLUX VALGUS S L





31575 DIAGNOSTIC LARYNGOSCOPY L

31576 LARYNGOSCOPY WITH BIOPSY L

31577 LARGSC W/RMVL FOREIGN BDY(S) S L

31578 LARGSC W/REMOVAL LESION S L

31579 LARYNGOSCOPY TELESCOPIC S L

31580 LARYNGOPLASTY LARYNGEAL WEB S L

31584 LARYNGOPLASTY FX RDCTJ FIXJ S L

31587 LARYNGOPLASTY CRICOID SPLIT S L

33405 REPLACEMENT AORTIC VALVE OPN S L



36476 ENDOVENOUS RF VEIN ADD-ON L

36479 ENDOVENOUS LASER VEIN ADDON L

38760 REMOVE GROIN LYMPH NODES L

47538 PERQ PLMT BILE DUCT STENT L

47539 PERQ PLMT BILE DUCT STENT L



24

CODE SHORT DESCRIPTION SHORT LONG 47540 PERQ PLMT BILE DUCT STENT L

62287 PERCUTANEOUS DISKECTOMY L

67101 REPAIR DETACHED RETINA CRTX S L

67105 REPAIR DETACHED RETINA PC S L

77002 NEEDLE LOCALIZATION BY XRAY L

77003 FLUOROGUIDE FOR SPINE INJECT L

77402 RADIATION TREATMENT DELIVERY L



81401 MOPATH PROCEDURE LEVEL 2 L



83015 HEAVY METAL QUAL ANY ANAL S L

83018 HEAVY METAL QUANT EACH NES S L

83704 LIPOPROTEIN BLD QUAN PART S L

87147 CULTURE TYPE IMMUNOLOGIC L

87197 BACTERICIDAL LEVEL SERUM L

87253 VIRUS INOCULATE TISSUE ADDL L

90632 HEPA VACCINE ADULT IM S

90633 HEPA VACC PED/ADOL 2 DOSE IM S

90634 HEPA VACC PED/ADOL 3 DOSE S

90644 HIB-MENCY VACC 6WK-18M0 IM S

90655 IIV3 VACC NO PRSV 0.25 ML IM S L


90657 IIV3 VACCINE SPLT 0.25 ML IM S L


90661 CCIIV3 VAC NO PRSV 0.5 ML IM S L





90734 MCV4 MENACWY VACCINE IM S L

90832 PSYTX W PT 30 MINUTES S L



25

CODE SHORT DESCRIPTION SHORT LONG 90833 PSYTX W PT W E/M 30 MIN S L


90836 PSYTX W PT W E/M 45 MIN S L


90838 PSYTX W PT W E/M 60 MIN S L

90846 FAMILY PSYTX W/O PT 50 MIN S L

90847 FAMILY PSYTX W/PT 50 MIN S L

92083 VISUAL FIELD EXAMINATION(S) L

92235 FLUORESCEIN ANGRPH UNI/BI S L

92240 ICG ANGIOGRAPHY UNI/BI S L

92602 REPROGRAM COCHLEAR IMPLT 7/> S

92612 ENDOSCOPY SWALLOW (FEES) VID S L

92613 ENDOSCOPY SWALLOW (FEES) I&R S L

92614 LARYNGOSCOPIC SENSORY VID S L

92615 LARYNGOSCOPIC SENSORY I&R S L

92616 FEES W/LARYNGEAL SENSE TEST L

92617 FEES W/LARYNGEAL SENSE I&R S L

92978 ENDOLUMINL IVUS OCT C 1ST S L

92979 ENDOLUMINL IVUS OCT C EA S L

97602 WOUND(S) CARE NON-SELECTIVE L

99487 CMPLX CHRON CARE W/O PT VSIT L

0274T PERQ LAMOT/LAM CRV/THRC L

0275T PERQ LAMOT/LAM LUMBAR L

0415T REPOS CAR MODULJ TRANVNS ELT L

0418T INTERRO EVAL CARDIAC MODULJ L

0419T DSTRJ NEUROFIBROMA XTNSV L

0420T DSTRJ NEUROFIBROMA XTNSV L

0439T MYOCRD CONTRAST PRFUJ ECHO L

0443T R-T SPCTRL ALYS PRST8 TISS L

3075F SYST BP GE 130 - 139MM HG L

3496F CD4+ CELL COUNT >= 500 CELLS L

3498F CD4+ CELL >=15% (HIV) L



26

CODE SHORT DESCRIPTION SHORT LONG 3570F RPRT BONE SCINT XREF W XRAY L

4194F PT RCV >=10MG DAILY PREDNISO L

4210F ACE/ARB THXPY FOR MOS/> S

A4221 Supp non-insulin inf cath/wk S L

A4720 Dialysat sol fld vol > 249cc L

A9599 Radioph dx b amyloid pet nos S L

B9002 Enter nutr inf pump any type S L

C1820 Generator neuro rechg bat sy S L

E0292 Hosp bed var ht no sr w/matt S

E0293 Hosp bed var ht no sr no mat S

E0296 Hosp bed total elect w/ matt L

E0627 Seat lift mech, electric any S L

E0629 Seat lift mech, non-electric S L

E0740 Non-implant pelv flr e-stim S L

E0967 Man wc rim/projection rep ea S L

E0995 Wc calf rest, pad replacemnt S L

E2206 Man wc whl lock comp repl ea S L

E2220 Solid propuls tire, repl, ea S L

E2221 Solid caster tire repl, each S L

E2222 Solid caster integ whl, repl S L

E2224 Propulsion whl excl tire rep S L

G0202 Scr mammo bi incl cad S L

G0204 Dx mammo incl cad bi S L

G0206 Dx mammo incl cad uni S L

G0281 Elec stim unattend for press L

G0296 Visit to determ ldct elig L

G0300 Hhs/hospice of lpn ea 15 min L

G0476 Hpv combo assay ca screen L

G8427 Docrev cur meds by elig clin S L

G8428 Cur meds not document L

G8430 Pt inelig med check L

G8431 Pos clin depres scrn f/u doc L

G8432 Dep scr not doc, rng S L



27

CODE SHORT DESCRIPTION SHORT LONG G8433 Scr dep not done, doc rsn S L

G8510 Scr dep neg, no plan reqd S L

G8511 Scr dep pos, no plan doc rng S L

G8598 Asa/antiplat ther used S L

G8599 No asa/antiplat ther use rng S L

G8649 Rafscrs knee no msr, no foto S L

G8653 Rafscrs hip, no msr, no surv S L

G8655 Rafscrs ft ank score >=0 S L

G8656 Rafscrs ft ank score < 0 S L

G8657 Rafscrs foot, no msr/no foto S L

G8658 Rafscrs foot, no msr/no surv S L

G8659 Rafscrs lumb score >= 0 S L

G8660 Rafscrs lumb score < 0 S L

G8661 Rafscrs lum, no msr/no foto S L

G8662 Rafscrs lum, no msr/no surv S L

G8665 Rafscrs shldr, no msr/foto S L

G8669 Rafscrs hand, no msr/surv S L

G8671 Rafscrs neck, score >/=0 S L

G8672 Rafscrs neck, score <0 S L

G8673 Rafscrs neck, no msr/no foto S L

G8674 Rafscrs neck, no msr/no foto S L

G8697 Antithromb no presc doc reas L

G8815 Doc reas no statin therapy L

G8924 Spir fev1/fvc<70%,fev<60% S L

G8925 Spir fev1/fvc>=60% & no copd S L

G8946 Mibm but no dx of breast ca L

G8968 Doc rsn no warf/anticog pres S L

G9229 Ptrsn no gc chl syp test L

G9231 Doc esrd dia trans preg L

G9232 Ptrsn no comm comorbid S L

G9239 Doc rsn hemod & cath acc S L

G9264 Doc rsn hemod w/cath >=90d S L

G9286 Antibio rx w in 10d of sympt L



28

CODE SHORT DESCRIPTION SHORT LONG G9298 Eval risk vte card 30d prior L

G9307 No ret for surg w in 30d L

G9308 Unpl ret or w/compl w/in 30d S L

G9326 Ct done no rad ds index, nrg S L

G9327 Ct done rad ds index S L

G9359 Doc of neg or man pos tb scn L

G9361 Doc rsn elect c-sec/induct S L

G9381 Doc med reas no offer eol L

G9416 Pt 1 tdap betw 10-13 yrs S L

G9417 Pt not 1 tdap betw 10-13 yrs S L

G9423 Med reas rpt no histo type L

G9424 Site no lung or lung cx L

G9448 Born 1945-1965 L

G9481 Remote e/m new pt 10mins L





G9486 Remote e/m est. pt 10mins L




G9490 Joint replac mod home visit L

G9497 Rec inst no smoke day surg S L

G9500 Rad expos ind/exp tm doc S L

G9501 Rad expos ind/exp tm no doc S L

G9519 Final ref +/- 0.5 w/in 90d S L

G9520 Refract not +/- 0.5 w/in 90d S L

G9531 Doc shnt/br tum/on antipl rx S L

G9532 Inj >24 hr in ed gcs <15 L

G9547 Incid finding liver/kid/adre S L

G9549 Doc med rsn for follow imag S L

G9551 Abd imag no les,kid/livr/adr S L



29

CODE SHORT DESCRIPTION SHORT LONG G9554 Ct/cta/mri/a chst foll rec S L

G9555 Doc med rsn for follup image S L

G9556 Ct/cta/mri/a no follup imag S L

G9557 Ct/cta/mri/a no thyr <1.0cm S L

G9559 Doc med reas no abx therapy

L

G9584 Eval opioid use instr/pt int

L

G9585 No eval opi use instr/intv

L

G9595 Doc shnt/tum/coag/thrombocyt S L

G9596 Hd inj >24h/gcs >15/no res

L

G9607 Doc rsn no interop cysto S L

G9609 Doc order anti-plat S L

G9610 Doc md rsn no antipla S L

G9611 No doc order anti-plat rng S L

G9625 Ptblad inj at surg/1mo post S L

G9626 Med rsn no rpt baldder inj S L

G9627 No bld inj at surg/1 mo pos S L

G9628 Bowel inj at surg/1mos post S L

G9629 Med rsn no rpt bowel inj S L

G9630 No bow inj at surg/1mos post S L

G9632 Med rsn for no rpt uret inj S L

G9633 No uret inj at surg/1mo post S L

G9642 Current smoker S L

G9660 Doc med rsn scope pt >85y

L

G9661 >85y scope othr rsn

L

G9676 40-75y w/type 1/2 w/ldl-c rs

L

G9678 Oncology care model service

L

J0573 Bupren/nal 3.1 to 6mg bupren

L

J0875 Injection, dalbavancin

L

J1745 Infliximab not biosimil 10mg S L

J1830 Interferon beta-1b / .25 mg

L

J3302 Triamcinolone diacetate inj

L

J3303 Triamcinolone hexacetonl inj

L

J3357 Ustekinumab sub cu inj, 1 mg S L



30

CODE SHORT DESCRIPTION SHORT LONG J7040 Normal saline solution infus

L

J7050 Normal saline solution infus

L

J7201 Factor ix alprolix recomb S L

J7297 Liletta, 52 mg S L

J7298 Mirena, 52 mg S L

J7301 Skyla, 13.5 mg S L

J7340 Carbidopa levodopa ent 100ml S L

J9033 Inj., treanda 1 mg S L

K0015 Detach non-adj ht armrst rep S L

K0019 Arm pad repl, each S L

K0037 Hi mount flip-up ftrest repl S L

K0042 Standard size ftplate rep ea S L

K0043 Ftrst lowr exten tube rep ea S L

K0044 Ftrst upr hanger brac rep ea S L

K0045 Ftrst compl assembly repl ea S L

K0046 Elev lgrst lwr exten repl ea S L

K0047 Elev legrst upr hangr rep ea S L

K0050 Ratchet assembly replacement S L

K0051 Cam rel asm ft/legrst rep ea S L

K0052 Swingaway detach ftrest repl S L

K0069 Rr whl compl sol tire rep ea S L

K0070 Rr whl compl pne tire rep ea S L

K0071 Fr cstr comp pne tire rep ea S L

K0072 Fr cstr semi-pne tire rep ea S L

K0077 Fr cstr asmb sol tire rep ea S L

K0098 Drive belt for pwc, repl S L

K0552 Sup/ext non-ins inf pump syr S L

L1906 Afo multilig ank sup pre ots

L

L3150 Abduct rotation bar w/o shoe

L

P9072 Plate path red/rapid bac tes S L

P9604 One-way allow prorated trip

L

Q0085 Chemo by both infusion and o

L

Q2039 Influenza virus vaccine, nos S L



31

CODE SHORT DESCRIPTION SHORT LONG Q4105 Integra drt or omnigraft S L

Q4131 Epifix or epicord S L

S0285 Cnslt before screen colonosc S S3620 Newborn metabolic screening

L


Installation Guide and Release Notes Appendix D: 2017 CPT/HCPCS Deleted Codes January 2017

32

Appendix D: 2017 CPT/HCPCS Deleted Codes

CODE SHORT DESCRIPTION 11752 REMOVE NAIL BED/TIP

21495 TREAT HYOID BONE FRACTURE

22305 CLOSED TX SPINE PROCESS FX

22851 APPLY SPINE PROSTH DEVICE

27193 TREAT PELVIC RING FRACTURE

27194 TREAT PELVIC RING FRACTURE

28290 CORRECTION OF BUNION



31582 REVISION OF LARYNX

31588 REVISION OF LARYNX

33400 REPAIR OF AORTIC VALVE

33401 VALVULOPLASTY OPEN

33403 VALVULOPLASTY W/CP BYPASS

35450 REPAIR ARTERIAL BLOCKAGE



35460 REPAIR VENOUS BLOCKAGE





36147 ACCESS AV DIAL GRFT FOR EVAL

36148 ACCESS AV DIAL GRFT FOR PROC

36870 PERCUT THROMBECT AV FISTULA

62310 INJECT SPINE CERV/THORACIC

62311 INJECT SPINE LUMBAR/SACRAL

62318 INJECT SPINE W/CATH CRV/THRC

62319 INJECT SPINE W/CATH LMB/SCRL

75791 AV DIALYSIS SHUNT IMAGING


CODE SHORT DESCRIPTION 75964 REPAIR ARTERY BLOCKAGE EACH


75968 REPAIR ARTERY BLOCKAGE EACH


77051 COMPUTER DX MAMMOGRAM ADD-ON

77052 COMP SCREEN MAMMOGRAM ADD-ON

77055 MAMMOGRAM ONE BREAST

77056 MAMMOGRAM BOTH BREASTS

77057 MAMMOGRAM SCREENING

80300 DRUG SCREEN NON TLC DEVICES

80301 DRUG SCREEN CLASS LIST A

80302 DRUG SCREEN PRSMPTV 1 CLASS

80303 DRUG SCREEN ONE/MULT CLASS

80304 DRUG SCREEN ONE/MULT CLASS

81280 LONG QT SYND GENE FULL SEQ

81281 LONG QT SYND KNOWN FAM VAR

81282 LONG QT SYN GENE DUP/DLT VAR

93965 EXTREMITY STUDY

97001 PT EVALUATION

97002 PT RE-EVALUATION

97003 OT EVALUATION

97004 OT RE-EVALUATION

97005 ATHLETIC TRAIN EVAL

97006 ATHLETIC TRAIN REEVAL

99143 MOD SEDAT PHYS/QHP <5 YRS

99144 MOD SEDAT PHYS/QHP 5YRS/>

99145 MOD SEDAT PHYS/QHP EA 15 MIN

99148 MOD SED DIFF PHYS/QHP<5 YRS

99149 MOD SED DIFF PHYS/QHP 5/>YRS

99150 MOD SED DIFF PHYS/QHP ADD ON

99420 HEALTH RISK ASSESSMENT TEST



33

CODE SHORT DESCRIPTION 0019T EXTRACORP SHOCK WV TX MS NOS

0169T PLACE STEREO CATH BRAIN

0171T LUMBAR SPINE PROCES DISTRACT

0172T LUMBAR SPINE PROCESS ADDL

0281T LAA CLOSURE W/IMPLANT

0282T PERIPH FIELD STIMUL TRIAL

0283T PERIPH FIELD STIMUL PERM

0284T PERIPH FIELD STIMUL REVISE

0285T PERIPH FIELD STIMUL ANALYS

0286T NEAR IFR SPECTRSC OF WOUNDS

0287T NEAR IFR GUIDE OF VASC SITE

0288T ANOSCOPY W/RF DELIVERY

0289T LASER INC FOR PKP/LKP DONOR

0291T IV OCT FOR PROC INIT VESSEL

0292T IV OCT FOR PROC ADDL VESSEL

0336T LAP ABLAT UTERINE FIBROIDS

0392T LAP ES SPH AUGMENT DEV PLACE

0393T ES SPH AUGMNT DEVICE REMOVAL

A4466 Elastic garment/covering

A9544 I131 tositumomab, dx

A9545 I131 tositumomab, rx

B9000 Enter infusion pump w/o alrm

C9121 Injection, argatroban

C9137 Adynovate factor viii recom

C9138 Nuwiq factor viii recomb

C9139 Idelvion, 1 i.u.

C9349 Puraply, puraply antimic

C9461 Choline c 11, diagnostic

C9470 Aripiprazole lauroxil im

C9471 Hymovis, 1 mg

C9472 Inj talimogene laherparepvec

C9473 Injection, mepolizumab

C9474 Inj, irinotecan liposome

CODE SHORT DESCRIPTION C9475 Injection, necitumumab

C9476 Injection, daratumumab

C9477 Injection, elotuzumab

C9478 Injection, sebelipase alfa

C9479 Instill, ciprofloxacin otic

C9480 Injection, trabectedin

C9481 Injection, reslizumab

C9742 Laryngoscopy with injection

C9800 Dermal filler inj px/suppl

E0628 Seat lift for pt furn-electr

G0163 Hhc lpn/rn obs/asses ea 15

G0164 Hhc lis nurse train ea 15

G0389 Ultrasound exam aaa screen

G0436 Tobacco-use counsel 3-10 min

G0437 Tobacco-use counsel>10min

G0464 Colorec ca scr, sto bas dna

G3001 Admin + supply, tositumomab

G8401 Pt inelig osteo screen measu

G8458 Pt inelig geno no antvir tx

G8460 Pt inelig rna no antvir tx

G8461 Pt rec antivir treat hep c

G8485 Report, diabetes measures

G8486 Report, prev care measures

G8487 Report ckd measures

G8489 Cad measures grp

G8490 Ra measures grp

G8491 Hiv/aids measures grp

G8494 Dm meas qual act perform

G8495 Ckd meas qual act perform

G8496 Prev care mg qual act perfrm

G8497 Cabg meas qual act perform

G8498 Cad meas qual act perform

G8499 Ra meas qual act perform



34

CODE SHORT DESCRIPTION G8500 Hiv meas qual act perform

G8544 Cabg measures grp

G8545 Hepc measures grp

G8548 Hf measures grp

G8549 Hepc mg qual act perform

G8551 Hf mg qual act perform

G8634 Pt no elg phar ther osteo

G8645 Asthma measures grp

G8646 Asthma mg qual act perform

G8725 Lipid profile perf doc

G8726 Doc reas no lipid profile

G8728 Lipid profile not perf

G8757 Copd mg qual act perform

G8758 Ibd mg qual act perform

G8759 Osa mg qual act perform

G8761 Dementia mg qual act perform

G8762 Pd mg qual act perform

G8765 Cataract mg qual act perform

G8784 Pt no elig for bp assess

G8848 Mild osa

G8853 Pos air press not prescribe

G8868 1st course antitnf

G8898 Copd measures group

G8899 Inflammatory bowel dis mg

G8900 Obstructive sleep apnea mg

G8902 Dementia measures group

G8903 Parkinson's disease mg

G8906 Cataract measures group

G8927 Adj chem pres ajcc iii

G8928 Adj chem not pres rsn spec

G8929 Adj cmo not pres rsn not gvn

G8940 Scr dep pos, no plan done

G8948 No neuropsych symptoms

CODE SHORT DESCRIPTION G8953 Oncology mg qual act perform

G8977 Oncology measures grp

G9203 Hep c rna done prior to med

G9204 No reason for no hep c rna

G9205 Hep c antiviral started

G9206 Hep c therapy started

G9207 Hep c genotype prior to med

G9208 No reason for no hep c geno

G9209 Hep c rna 4to12 wk after med

G9210 No hepc rna after med docrsn

G9211 No hepc rna after med no rsn

G9217 No pcp proph low cd4 norsn

G9219 No oder pjp for med reason

G9222 Pjp proph ordered low cd4

G9233 Tkr composite

G9234 Tkr intent

G9235 Gs mg composite

G9236 Op rad mg composite

G9237 Gs mg intent

G9238 Op rad mg intent

G9244 Antiviral not ordered

G9245 Antiviral ordered

G9324 Not all data norsn

G9435 Asp presc disch

G9436 Asp not presc doc reas

G9437 Asp not presc disch

G9438 P2y inhib presc

G9439 P2y inhib not presc doc reas

G9440 P2y inhib not presc

G9441 Statin presc disch

G9442 Statin not presc doc reas

G9443 Statin not presc disch

G9463 Sinusitis intent



35

CODE SHORT DESCRIPTION G9464 Sinusitis comp

G9465 Aoe intent

G9466 Aoe comp

G9467 Recd cortico >=10mg/day >60d

G9499 No start/rec antvir tx hep c

G9572 Phq-scr >9 doc in 12m time

G9581 Md doc, door to punc tm >2hr

G9619 Doc rsn no scr uter malig

G9650 Doc pt no ther chg or contra

G9652 Pt tx sys bio med psori 6mth

G9653 Pt no tx sys bio rx 6 mths

G9657 Toc dur aneth to icu

G9667 Doc med rsn no stat tx/presc

G9669 Intend rpt mult chr msr grp

G9670 Qty act mcc mg perf

G9671 Intend rpt dia retin msr grp

G9672 Qty act diab retin mg perf

G9673 Intend rpt card prev msr grp

G9677 Qty act card prev mg perf

J0760 Colchicine injection

J1590 Gatifloxacin injection

K0901 Ko single upright pre ots

K0902 Ko double upright pre ots

Q4119 Matristem wound matrix

Q4120 Matristem burn matrix

Q4129 Unite biomatrix

Q9980 Genvisc, inj, 1mg

Q9981 Rolapitant, oral, 1mg

S8032 Low dose ct lung screening


Installation Guide and Release Notes Appendix E : 2017 CPT/HCPCS Modifier Codes January 2017

36

Appendix E : 2017 CPT/HCPCS Modifier Codes CODE SHORT DESCRIPTION NEW STATUS SHORT LONG 25 SIGNIFICANT, SEPARATE ID E/M S L

95 SYNCHRONOUS TELEMEDICINE SERVI N

FX X-RAY TAKEN USING FILM N

L1 SEPARATELY PAYABLE LAB TEST I

PN NON-EXCEPTED OFF-CAMPUS SVC N

PO EXCEPTED OFF-CAMPUS SERVICE S L

Q2 DEMO PROCEDURE, SERVICE S L

V1 DEMONSTRATION MODIFIER 1 N




Installation Guide and Release Notes Glossary January 2017

37

Glossary

CPT Codes One of several codes sets used by the healthcare industry to standardize data, allowing for comparison and analysis. Current Procedural Terminology was developed and is updated annually by the American Medical Association and is widely used in producing bills for services rendered to patients. CPTs include codes for diagnostic and therapeutic procedures, and specify information that differentiates the codes based on cost. CPT codes are the most widely accepted nomenclature in the United States for reporting physician procedures and services for federal and private insurance third-party reimbursement.

FileMan The database management system for RPMS.

KIDS Kernel Installation and Distribution System consists of programs that function as a set of standard software tools. These tools provide a uniform interface between the underlying operating system and Veterans Health Information Systems and Technology Architecture (VistA) application modules. Kernel supports VistA modules through the coordination of database, device, menu management, background job scheduling, security, auditing, and programming functions. Kernel Installation and Distribution System is the module that is used to install the appropriate tools for each application.

RPMS Resource and Patient Management System is a decentralized integrated solution for management of both clinical and administrative information in these healthcare facilities. Flexible hardware configurations, over 50 software applications, and network communication components combine to create a comprehensive clinical, financial, and administrative solution; a solution that can stand alone or function in concert with other components as needed.


Installation Guide and Release Notes Acronym List January 2017

38

Acronym List

Acronym Term Meaning IHS Indian Health Service

RPMS Resource and Patient Management System

CPT Current Procedural Terminology

HCP Health Care Professionals

FY Fiscal Year

CY Calendar Year

KIDS Kernel Installation and Distribution System

FARS Federal Acquisition Regulation Supplement

DFARS Defense Federal Acquisition Regulation Supplement

OIT Office of Information Technology


Installation Guide and Release Notes Contact Information January 2017

39

Contact Information

If you have any questions or comments regarding this distribution, please contact the OIT Help Desk (IHS).

Phone: (888) 830-7280 (toll free)

Web: http://www.ihs.gov/helpdesk/

Email: [email protected]

http://www.ihs.gov/helpdesk/

mailto:[email protected]

Current Procedural Terminology CPT Update (ACPT) · 2017-01-06 · Current Procedural Terminology CPT Update (ACPT) Version 2.17 Installation Guide and Release Notes Installation

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