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CODE.MODE

MEDICINE

Medicine Codes 

Medicine Codes are one of the six sections of the CPT Category I codes and range from 90281-99607.

Guidelines

Add-on Codes +

An add-on code is an additional or supplementary procedure in addition to the primary procedure being performed. These are designated with the + symbol and are listed in Appendix D. Tip: Look for "each additional" or "(List separately to primary procedure."

  • ALWAYS reported with primary 

  • NEVER a stand-alone Code

  • NEVER reported with Modifier -51

Separate Procedures

Codes designated as "separate procedure" are NOT reported in addition to the code for the total procedure or service of which it is considered an integral component. 

Codes designated as "separate procedure" MAY be  reported by itself or in addition to another procedure / service by adding Modifer -59 to the "separate procedure" code IF they are carried out independently or considered unrelated or distinct. (Examples include a different session or encounter, a different procedure or surgery, different site/organ system, separate incision/excision, separate lesion, separate injury, or area of injury in extensive injuries.) 

Unlisted Procedure / Service

Unlisted codes are reported for services that are not included in the CPT book. If reporting such a service, the appropriate "Unlisted Procedure" code may be used to indicate the service, identifying it as a "Special Report." 

Special Report

Some services that are new, rarely provided, variable, or unusual require a special report. These reports must include pertinent  information, including a description of the following:

  • nature, extent, & need for procedure

  • time, effort, & equipment necessary

Imaging Guidance 

Guidelines for image documentation for Radiology (Including nuclear Medicine and Diagnostic Ultrasound) will apply when imaging or imaging supervision and interpretation is included in a procedure. 

RANGE

90281-99607

SUBSECTIONS

  • Immune Globulins, Serum or Recombinant Products

  • Immunization Administration for Vaccines/Toxoids

  • Vaccines, Toxoids

  • Psychiatry

  • Biofeedback

  • Dialysis

  • Gastroenterology

  • Opthalmology

  • Special Otorhinolaryngologic Services

  • Cardiovascular

  •  Noninvasive Vascular Diagnostic Studies

  • Pulmonary

  • Allery & Clinical Immunology

  • Endocrinology

  • Neurology and Neruomuscular Procedures

  • Medical Genetics & Genetic Counseling Services

  • Central Nervous System Assessments/ Tests

  • Health and Behavior Assessment/ Intervention

  • Hydration, Therapeutic, Prophyactic, Diagnostis Injections & Infusions, and Chemotherapy and Other Highly Complex Drug or Highly Complex Biologic Agent Administration

  • Photostatic Therapy

  • Special Dermatological Procedures

  • Physical Medicine & Rehabilitation

  • Medical Nutrition Therapy

  • Acupuncture

  • Osteopathic Manipulative Treatment

  • Chiropractic Manipulative Treatment

  • Education and Training for Patient Self-management

  • Non-Face-To-Face Non-physician Services

  • Special Services, procedures & Reports

  • Qualifying Circumstances for Anesthesia 

  • Moderate (Conscious) Sedation

  • Other Services & Procedures

  • Home Health Procedures/ Services

  • Medication Therapy Management Services

MODIFIERS

  • CPT Category I Modifiers
  • Anesthesia Modifiers 

HELPFUL LINKS

Coding

Supplied Materials

Supplies and materials exceeding those usually included may be listed separately.  

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