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CODE.MODE

MEDICINE

Medicine Codes 

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

Guidelines

Add-on Codes +

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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."

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  • ALWAYS reported with primary 

  • NEVER a stand-alone Code

  • NEVER reported with Modifier -51

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Separate Procedures

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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. 

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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.) 

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Unlisted Procedure / Service

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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

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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: ​

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  • nature, extent, & need for procedure

  • time, effort, & equipment necessary

Imaging Guidance 

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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

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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

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  • CPT Category I Modifiers
  • Anesthesia Modifiers 

HELPFUL LINKS

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Coding

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Supplied Materials

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

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