Evaluation and Management
99217 Observation care discharge day management (This code is to be utilized to report all services provided to a patient on discharge from outpatient hospital “observation status” if the discharge is on other than the initial date of “observation status.” To report services to a patient designated as “observation status” or “inpatient status” and discharged on the same date, use the codes for Observation or Inpatient Care Services [including Admission and Discharge Services, 99234-99236 as appropriate.])
99218 Initial observation care, per day, for the evaluation and management of a patient which requires these 3 key components:
A detailed or comprehensive history;
A detailed or comprehensive examination; and
Medical decision making that is straightforward or of low complexity.
Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient’s and/or family’s needs.
Usually, the problem(s) requiring admission to outpatient hospital “observation status” are of low severity. Typically, 30 minutes are spent at the bedside and on the patient’s hospital floor or unit.
99219 Initial observation care, per day, for the evaluation and management of a patient, which requires these 3 key components:
A comprehensive history;
A comprehensive examination; and
Medical decision making of moderate complexity.
Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient’s and/or family’s needs.
Usually, the problem(s) requiring admission to outpatient hospital “observation status” are of moderate severity. Typically, 50 minutes are spent at the bedside and on the patient’s hospital floor or unit.
99220 Initial observation care, per day, for the evaluation and management of a patient, which requires these 3 key components:
A comprehensive history;
A comprehensive examination; and
Medical decision making of high complexity.
Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient’s and/or family’s needs.
Usually, the problem(s) requiring admission to outpatient hospital “observation status” are of high severity. Typically, 70 minutes are spent at the bedside and on the patient’s hospital floor or unit.
17250 Chemical cauterization of granulation tissue (ie, proud flesh) sinus or fistula)
31254 Nasal/sinus endoscopy, surgical; with ethmoidectomy, with ethmoidectomy;partial (anterior)
31255 with ethmoidectomy;total (anterior and posterior)
31276 Nasal/sinus endoscopy, surgical with frontal sinus exploration, with or without including removal of tissue from frontal sinus,when performed
31645 with therapeutic aspiration of tracheobronchial tree, initial (eg, drainage of lung abscess)
31646 with therapeutic aspiration of tracheobronchial tree, subsequent, same hospital stay
32998 Ablation therapy for reduction or eradication of 1 or more pulmonary tumor(s) including pleura or chest wall when involved by tumor extension, percutaneous, radiofrequency including imaging guidance when performed, unilateral; radiofrequency
34812 Open femoral artery exposure for delivery of endovascular prosthesis, by groin incision, unilateral (List separately in addition to code for primary procedure)
34820 Open iliac artery exposure for delivery of endovascular prosthesis or iliac occlusion during endovascular therapy, by abdominal or retroperitoneal incision, unilateral (List separately in addition to code for primary procedure)
34833 Open iliac artery exposure with creation of conduit for delivery of aortic or iliac endovascular prosthesis or for establishment of cardiopulmonary bypass, by abdominal or retroperitoneal incision, unilateral (List separately in addition to code for primary procedure)
34834 Open brachial artery exposure to assist in the deployment of aortic or iliac endovascular prosthesis by arm incision, unilateraly for delivery of endovascular prosthesis, unilateral (List separately in addition to code for primary procedure)
36140 Introduction of needle or intracatheter, upper or lower extremity artery extremity artery
36468 Single or multiple injections Injection(s) of sclerosing solutions;sclerosant for spider veins (telangiectasia), limb or trunk
36470 Injection of sclerosin solution sclerosant; single incompetent vein (other than telangiectasia)
36471 multiple incompetent veins (other than telangiectasia), same leg
36516 with extracorporeal immunoadsorption, selective adsorption or selective filtration and plasma reinfusion
36908 Transcatheter placement of intravascular stent(s), central dialysis segment, performed through dialysis circuit, including all imaging and radiological supervision and interpretation required to perform the stenting, and all angioplasty in the central dialysis segment (List separately in addition to code for primary procedure)
38220 Bone Diagnostic bone marrow; aspiration only(s)
38221 biopsy; needle or tracar(ies)
43112 Total or near total esophagectomy, with thoracotomy; with pharyngogastrostomy or cervical esophagogastrostomy, with or without pyloroplasty (ie, McKeown esophagectomy or tri-incisional esophagectomy)
57240 Anterior colporrhaphy, repair of cystocele with or without repair of urethrocele, including cystourethroscopy, when performed
57260 Combined anteroposterior colporrhaphy, including cystourethroscopy, when performed;
57265 with enterocele repair
64550 Application of surface (transcutaneous) neurostimulator (eg, TENS unit)
76000 Fluoroscopy (separate procedure), up to 1 hour physician or other qualified health care professional time other than 71023 or 71034 (eg, cardiac fluoroscopy)
76881 Ultrasound, extremity, nonvascular; complete joint (ie, joint space and peri-articular soft tissue structures) real-time with image documentation: complete
76882 Ultrasound, limited, anatomic specific joint or other nonvascular extremity structure(s) (eg, joint space, peri-articular tendon[s], muscle[s], nerve[s], other soft tissue structure[s], or soft tissue mass[es]), real-time with image documentation
80305 Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; (eg, immunoassay); capable of being read by direct optical observation only (eg, dipsticks utilizing immunoassay [eg, dipsticks, cups, cards, or cartridges]), includes sample validation when performed, per date of service
80306 read by instrument assisted direct optical observation (eg, dipsticks utilizing immunoassay [eg, dipsticks, cups, cards, or cartridges]), includes sample validation when performed, per date of service
80307 by instrument chemistry analyzers (eg, utilizing immunoassay [eg, EIA, ELISA, EMIT, FPIA, IA, KIMS, RIA]), chromatography (eg, GC, HPLC), and mass spectrometry either with or without chromatography, (eg, DART, DESI, GC-MS, GC-MS/MS, LC-MS, LC-MS/MS, LDTD, MALDI, TOF) includes sample validation when performed, per date of service
81257 HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis;, for common deletions or variant (eg, Southeast Asian, Thai, Filipino, Mediterranean, alpha3.7, alpha4.2, alpha20.5, Constant Spring)
81400 Molecular pathology procedure, Level 1 (eg, identification of single germline variant [eg, SNP] by techniques such as restriction enzyme digestion or melt curve analysis)
DPYD (dihydropyrimidine dehydrogenase) (eg, 5-fluorouracil/5-FU and capecitabine drug metabolism), IVS14+1GA variant
Human Platelet Antigen 1 genotyping (HPA-1), ITGB3 (integrin, beta 3 [platelet glycoprotein IIIa], antigen CD61 [GPIIIa]) (eg, neonatal alloimmune thrombocytopenia [NAIT], post-transfusion purpura), HPA-1a/b (L33P)
Human Platelet Antigen 2 genotyping (HPA-2), GP1BA (glycoprotein Ib [platelet], alpha polypeptide [GPIba]) (eg, neonatal alloimmune thrombocytopenia [NAIT], post-transfusion purpura), HPA-2a/b (T145M)
Human Platelet Antigen 3 genotyping (HPA-3), ITGA2B (integrin, alpha 2b [platelet glycoprotein IIb of IIb/IIIa complex], antigen CD41 [GPIIb]) (eg, neonatal alloimmune thrombocytopenia [NAIT], post-transfusion purpura), HPA-3a/b (I843S)
Human Platelet Antigen 4 genotyping (HPA-4), ITGB3 (integrin, beta 3 [platelet glycoprotein IIIa], antigen CD61 [GPIIIa]) (eg, neonatal alloimmune thrombocytopenia [NAIT], post-transfusion purpura), HPA-4a/b (R143Q)
Human Platelet Antigen 5 genotyping (HPA-5), ITGA2 (integrin, alpha 2 [CD49B, alpha 2 subunit of VLA-2 receptor] [GPIa]) (eg, neonatal alloimmune thrombocytopenia [NAIT], post-transfusion purpura), HPA-5a/b (K505E)
Human Platelet Antigen 6 genotyping (HPA-6w), ITGB3 (integrin, beta 3 [platelet glycoprotein IIIa, antigen CD61] [GPIIIa]) (eg, neonatal alloimmune thrombocytopenia [NAIT], post-transfusion purpura), HPA-6a/b (R489Q)
Human Platelet Antigen 9 genotyping (HPA-9w), ITGA2B (integrin, alpha 2b [platelet glycoprotein IIb of IIb/IIIa complex, antigen CD41] [GPIIb]) (eg, neonatal alloimmune thrombocytopenia [NAIT], post-transfusion purpura), HPA-9a/b (V837M)
Human Platelet Antigen 15 genotyping (HPA-15), CD109 (CD109 molecule) (eg, neonatal alloimmune thrombocytopenia [NAIT], post-transfusion purpura), HPA-15a/b (S682Y)
IL28B (interleukin 28B [interferon, lambda 3]) (eg, drug response), rs12979860 variant
SLCO1B1 (solute carrier organic anion transporter family, member 1B1) (eg, adverse drug reaction), V174A variant
81401 Molecular pathology procedure, Level 2 (eg, 2-10 SNPs, 1 methylated variant, or 1 somatic variant [typically using nonsequencing target variant analysis], or detection of a dynamic mutation disorder/triplet repeat)
CYP3A4 (cytochrome P450, family 3, subfamily A, polypeptide 4) (eg, drug metabolism), common variants (eg, *2, *3, *4, *5, *6)
CYP3A5 (cytochrome P450, family 3, subfamily A, polypeptide 5) (eg, drug metabolism), common variants (eg, *2, *3, *4, *5, *6)
HBB (hemoglobin, beta) (eg, sickle cell anemia, hemoglobin C, hemoglobin E), common variants (eg, HbS, HbC, HbE)
LINC00518 (long intergenic non-protein coding RNA 518) (eg, melanoma), expression analysis
PRAME (preferentially expressed antigen in melanoma) (eg, melanoma), expression analysis
TPMT (thiopurine S-methyltransferase) (eg, drug metabolism), common variants (eg, *2, *3)
TYMS (thymidylate synthetase) (eg, 5-fluorouracil/5-FU drug metabolism), tandem repeat variant
81403 Molecular pathology procedure, Level 4 (eg, analysis of single exon by DNA sequence analysis, analysis of 10 amplicons using multiplex PCR in 2 or more independent reactions, mutation scanning or duplication/deletion variants of 2-5 exons)
HBB (hemoglobin, beta, beta-globin) (eg, beta thalassemia), duplication/deletion analysis
IDH1 (isocitrate dehydrogenase 1 [NADP+], soluble) (eg, glioma), common exon 4 variants (eg, R132H, R132C)
IDH2 (isocitrate dehydrogenase 2 [NADP+], mitochondrial) (eg, glioma), common exon 4 variants (eg, R140W, R172M)
81404 Molecular pathology procedure, Level 5 (eg, analysis of 2-5 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 6-10 exons, or characterization of a dynamic mutation disorder/triplet repeat by Southern blot analysis)
HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia), duplication/deletion analysis
HBB (hemoglobin, beta, Beta-Globin) (eg, thalassemia), full gene sequence
81405 Molecular pathology procedure, Level 6 (eg, analysis of 6-10 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 11-25 exons, regionally targeted cytogenomic array analysis)
CPOX (coproporphyrinogen oxidase) (eg, hereditary coproporphyria), full gene sequence
CTRC (chymotrypsin C) (eg, hereditary pancreatitis), full gene sequence
F9 (coagulation factor IX) (eg, hemophilia B), full gene sequence
HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, thalassemia), full gene sequence
PKLR (pyruvate kinase, liver and RBC) (eg, pyruvate kinase deficiency), full gene sequence
81406 Molecular pathology procedure, Level 7 (eg, analysis of 11-25 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 26-50 exons, cytogenomic array analysis for neoplasia)
ANOS1 (anosmin-1) (eg, Kallmann syndrome 1), full gene sequence
HMBS (hydroxymethylbilane synthase) (eg, acute intermittent porphyria), full gene sequence
KAL1 (Kallmann syndrome 1 sequence) (eg, Kallmann syndrome), full gene sequence
PPOX(protoporphyrinogen oxidase) (eg, variegate porphyria), full gene sequence
