2019 CPT-4 And HCPCS Codes Subject To CLIA Edits
2019 CPT-4 and HCPCS Codes Subject to CLIA EditsIncludes non-waived and non-PPMP testsLaboratory certification codes are for informational purposes only.CPT only copyright 2018 American Medical Association. All rights reservedCPT is a registered trademark of the American Medical Association.Applicable FARS/DFARS Apply to Government Use.Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA,are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practicemedicine or dispense medical services. The AMA assumes no liability for data contained or not contained 7UMODTC26DESCRIPTIONPsa, screeningScreen cerv/vag thin layerScreen c/v thin layer by MDScr c/v cyto,autosys and mdScr c/v cyto,thinlayer,rescrScr c/v cyto,thinlayer,rescrScr c/v cyto,thinlayer,rescrScr c/v cyto, automated sysScr c/v cyto, autosys, rescrCBC/diffwbc w/o plateletCBC without plateletFecal blood scrn immunoassayProstate biopsy, any mthdProstate biopsy, any mthdProstate biopsy, any mthdEIA HIV-1/HIV-2 screenELISA HIV-1/HIV-2 screenOral HIV-1/HIV-2 screenHepatitis c antibody screening, for individual at high risk andother covered indication(s)Hiv combination assayHpv combo assay ca screenDrug test def 1-7 classesDrug test def 8-14 classesDrug test def 15-21 classesDrug test def 22 classesHepb screen high risk indivDrug test def simple all clWarfarin respon genetic testScreen pap by tech w md supvScreening pap smear by physCulture bacterial urineLong-chain omega-3 fatty acids in red blood cell membranesRbc dna hea 35 ag 11 bld grpOnc clrct 3 ur metab alg plpOnc ovar 5 prtn ser alg scorOnco prst8 3 gene ur algDetc ia meds 120 analytesRx test prsmv ur w/def confLABORATORY CERTIFICATION (LC)CODE310630630630630630630630630400400310, 400610610610140, 220140, 220140, 220220140, 220140340340340340220340220, 310630630110310510220, 310220, 310220, 310340340
0048U0049UMODDESCRIPTIONHpylori detcj abx rstnc dnaOnc brst ca erbb2 amp/nonampNfct ds strn typ whl gen seqRx mntr lc-ms/ms oral fluidGermln do gene reargmt detcjOnc sld org neo gene reargmtHem hmtlmf neo gene reargmtOnc hmtlmf neo rna bcr/abl1Onc hmtlmf neo jak2 mut dnaMicroRNA gene analysis of thyroid nodule tissue - Effective10/1/2017RNA gene analysis of tumor tissue - Effective 10/1/2017Rx test prsmv ur w/def conf - Discontinued 9/30/2018Onc prst8 detcj 8 autoantb - Effective 10/1/2017Trgt gen seq dna&rna 23 gene - Effective 10/1/2017Onc aml dna detcj/nondetcj - Effective 10/1/2017Glyca nuc mr spectrsc quan - Effective 1/1/2019Tenofovir liq chrom ur quan - Effective 1/1/2019Onc thyr dna&mrna 112 genes - Effective 1/1/2019Jak2 gene trgt seq alys - Effective 1/1/2019Cyp2d6 gene cpy nmr cmn vrnt - Discontinued 9/30/2018Rx metab advrs trgt seq alys - Effective 1/1/2019Rx metab warf trgt seq alys - Effective 1/1/2019Cyp1a2 gene - Effective 1/1/2019Comt gene - Effective 1/1/2019Htr2a htr2c genes - Effective 1/1/2019Tpmt nudt15 genes - Effective 1/1/2019Neuro csf prion prtn qual - Effective 4/1/2018Xome tum & nml spec seq alys - Effective 4/1/2018Trgt gen seq dna 324 genes - Effective 4/1/2018Vitamin d srm microsamp quan - Effective 4/1/2018Dna antb 2strand hi avidity - Effective 4/1/2018Gene analysis (t(9;22)) for translocation analysis - Effective4/1/2018B brgdrferi antb 5 prtn igm - Effective 4/1/2018B brgdrferi antb 12 prtn igg - Effective 4/1/2018Tbrf b grp antb 4 prtn igm - Effective 4/1/2018Tbrf b grp antb 4 prtn igg - Effective 4/1/2018Onc brst dux carc is 12 gene - Effective 7/1/2018Flt3 gene itd variants quan - Effective 7/1/2018Onc prst8 mrna 17 gene alg - Effective 7/1/2018Onc sld org neo dna 468 gene - Effective 7/1/2018Npm1 gene analysis quan - Effective 7/1/2018LABORATORY CERTIFICATION (LC)CODE110220, 310110340220, 310220, 310400220, 310, 400220, 310, 400220, 310220, 310340220, 310220, 310220, 310, 400220, 310220, 310220, 310310, 900220, 310220, 310220, 310220, 310220, 310220, 310220, 310310220, 310220, 310310220220, 310, 400220220220220220, 310220, 310, 410220, 310220, 310220, 310, 410CPT only copyright 2018 American Medical Association. All rights reserved.2
0081UMODDESCRIPTIONTrgt gen seq dna 194 genes - Effective 7/1/2018Rx mntr lc-ms/ms ur 31 pnl - Effective 7/1/2018Lpoprtn bld w/5 maj classes - Effective 7/1/2018Onc prst8 ca fish alys 4 gen - Effective 7/1/2018Rx mntr 14 drugs & sbsts - Effective 7/1/2018Card hrt trnspl 96 dna seq - Effective 7/1/2018Hem aml dna gene reargmt - Effective 7/1/2018Onc sld org neo mrna 51 gene - Effective 7/1/2018Onc merkel cll carc srm quan - Effective 7/1/2018Onc merkel cll carc srm /- - Effective 7/1/2018Twn zyg gen seq alys chrms2 - Effective 7/1/2018Ai sle igg&igm alys 80 bmrk - Effective 10/1/2018Neuro autism 32 amines alg - Effective 10/1/2018Antb tp total&rpr ia qual - Effective 10/1/2018Syfls tst nontreponemal antb - Effective 10/1/2018Pamg-1 ia cervico-vag fluid - Effective 10/1/2018Onc brst imhchem prfl 4 bmrk - Effective 10/1/2018Candida species pnl amp prb - Effective 10/1/2018Onc clrct microrna mir-31-3p - Effective 10/1/2018Cyp2d6 gen com&slct rar vrnt - Effective 10/1/2018Cyp2d6 full gene sequence - Effective 10/1/2018Cyp2d6 gen cyp2d6-2d7 hybrid - Effective 10/1/2018Cyp2d6 gen cyp2d7-2d6 hybrid - Effective 10/1/2018Cyp2d6 nonduplicated gene - Effective 10/1/2018Cyp2d6 5' gene dup/mlt - Effective 10/1/2018Cyp2d6 3' gene dup/mlt - Effective 10/1/2018Ig paraprotein qual bld/ur - Effective 10/1/2018Pain mgt opi use gnotyp pnl - Effective 10/1/2018Oncology (lung), mass spectrometric analysis of galectin-3binding protein and scavenger receptor cysteine-rich type 1protein M130, with five clinical risk factors (age, smoking status,nodule diameter, nodule-spiculation status and nodule location),utilizing plasma, algorithm reported as a categorical probabilityof malignancy - Effective 1/1/2019Oncology (uveal melanoma), mRNA, gene-expression profilingby real-time RT-PCR of 15 genes (12 content and 3housekeeping genes), utilizing fine needle aspirate or formalinfixed paraffin-embedded tissue, algorithm reported as risk ofmetastasis - Effective 1/1/2019LABORATORY CERTIFICATION (LC)CODE220, 310, 410340310220, 310340220, 310400220, 310220, 310220, 310900220, 310220, 310, 900210210310220, 310120220, 310220, 310220, 310220, 310220, 310220, 310220, 310220, 310310220, 310220, 310CPT only copyright 2018 American Medical Association. All rights reserved.220, 3103
HCPCSMOD0082ULABORATORY CERTIFICATION (LC)CODEDrug test(s), definitive, 90 or more drugs or substances,definitive chromatography with mass spectrometry, andpresumptive, any number of drug classes, by instrumentchemistry analyzer (utilizing immunoassay), urine, report ofpresence or absence of each drug, drug metabolite orsubstance with description and severity of significantinteractions per date of service - Effective 1/1/2019Oncology, response to chemotherapy drugs using motilitycontrast tomography, fresh or frozen tissue, reported aslikelihood of sensitivity or resistance to drugs or drugcombinations - Effective TC26Mohs, 1 stage, h/n/hf/gMohs addl stageMohs, 1 stage, t/a/lMohs, addl stage, t/a/lMohs surg, addl blockPlasma volume, singlePlasma volume, singlePlasma volume singlePlasma volume, multiplePlasma volume, multiplePlasma volume multipleRed cell mass, singleRed cell mass, singleRed cell mass singleRed cell mass, multipleRed cell mass, multipleRed cell mass multipleBlood volumeBlood volumeBlood volumeRed cell survival studyRed cell survival studyRed cell survival studyPlatelet survivalPlatelet survivalPlatelet survivalVit B-12 absorption exam - Discontinued 12/31/2018Vit B-12 absorption exam - Discontinued 12/31/2018Vit B-12 absorption exam - Discontinued 12/31/2018Vit B-12 absorp exam, int fac - Discontinued 12/31/2018Vit B-12 absorp exam, int fac - Discontinued 12/31/2018Vit b-12 absrp exam int fac - Discontinued 12/31/2018Vit B-12 absorp, combined - Discontinued 12/31/2018Vit B-12 absorp, combined - Discontinued 12/31/2018Vit b-12 absorp combined - Discontinued 12/31/2018Metabolic panel ionized caMetabolic panel total caGeneral health panel - Not payable by Medicare340220, 00800800310310310, 330, 400CPT only copyright 2018 American Medical Association. All rights reserved.4
80321MODDESCRIPTIONElectrolyte panelComprehen metabolic panelObstetric panel - Not valid for MedicareLipid panelRenal function panelAcute hepatitis panelHepatic function panelObstetric panelAssay of amikacinDrug assay caffeineAssay, carbamazepine, totalAssay, carbamazepine, freeDrug assay cyclosporineDrug assay clozapineAssay of digoxin totalAssay of digoxin freeAssay dipropylacetic acd totDipropylacetic acid freeAssay of ethosuximideDrug screen quant everolimusAssay of gentamicinDrug screen quant gabapentinAssay of haloperidolDrug screen quan lamotrigineAssay of lidocaineDrug scrn quan levetiracetamAssay of lithiumDrug scrn quan mycophenolateDrug scrn quant oxcarbazepinAssay of phenobarbitalAssay of phenytoin, totalAssay of phenytoin, freeAssay of primidoneAssay of procainamideAssay of procainamideAssay of quinidineAssay of sirolimusAssay of tacrolimusAssay of theophyllineDrug screen quant tiagabineAssay of tobramycinAssay of topiramateAssay of vancomycinDrug screen quant zonisamideQuantitative assay, drugDrug test prsmv dir opt obsDrug test prsmv instrmntDrug test prsmv chem anlyzrDrug screen quantalcohols - Not payable by MedicareAlcohols biomarkers 1or 2 - Not payable by MedicareLABORATORY CERTIFICATION (LC)CODE310310210, 220, 400, 530310310220310210, 220, 400, 510, 40340340340340340340340340340CPT only copyright 2018 American Medical Association. All rights reserved.5
80371MODDESCRIPTIONLABORATORY CERTIFICATION (LC)CODEAlcohols biomarkers 3/more - Not payable by MedicareAlkaloids nos - Not payable by MedicareDrug screen amphetamines 1/2 - Not payable by MedicareAmphetamines 3or 4 - Not payable by MedicareAmphetamines 5 or more - Not payable by MedicareAnabolic steroid 1 or 2 - Not payable by MedicareAnabolic steroid 3 or more - Not payable by MedicareAnalgesics non-opioid 1 or 2 - Not payable by MedicareAnalgesics non-opioid 3-5 - Not payable by MedicareAnalgesics non-opioid 6/more - Not payable by MedicareAntidepressants class 1 or 2 - Not payable by MedicareAntidepressants class 3-5 - Not payable by MedicareAntidepressants class 6/more - Not payable by MedicareAntidepressant tricyclic 1/2 - Not payable by MedicareAntidepressant tricyclic 3-5 - Not payable by MedicareTricyclic & cyclicals 6/more - Not payable by MedicareAntidepressant not specified - Not payable by MedicareAntiepileptics nos 1-3 - Not payable by MedicareAntiepileptics nos 4-6 - Not payable by MedicareAntiepileptics nos 7/more - Not payable by MedicareAntipsychotics nos 1-3 - Not payable by MedicareAntipsychotics nos 4-6 - Not payable by MedicareAntipsychotics nos 7/more - Not payable by MedicareDrug screening barbiturates - Not payable by MedicareBenzodiazepines1-12 - Not payable by MedicareBenzodiazepines 13 or more - Not payable by MedicareDrug screening buprenorphine - Not payable by MedicareCannabinoids natural - Not payable by MedicareCannabinoids synthetic 1-3 - Not payable by MedicareCannabinoids synthetic 4-6 - Not payable by MedicareCannabinoid synthetic 7/more - Not payable by MedicareDrug screening cocaine - Not payable by MedicareDrug screening fentanyl - Not payable by MedicareGabapentin non-blood - Not payable by MedicareHeroin metabolite - Not payable by MedicareKetamine and norketamine - Not payable by MedicareDrug screening methadone - Not payable by MedicareMethylenedioxyamphetamines - Not payable by MedicareMethylphenidate - Not payable by MedicareOpiates 1 or more - Not payable by MedicareOpioids & opiate analogs 1/2 - Not payable by MedicareOpioids & opiate analogs 3/4 - Not payable by MedicareOpioid &opiate analog 5/more - Not payable by MedicareDrug screening oxycodone - Not payable by MedicareDrug screening pregabalin - Not payable by MedicareDrug screening propoxyphene - Not payable by MedicareSedative hypnotics - Not payable by MedicareSkeletal muscle relaxant 1/2 - Not payable by MedicareSkel musc relaxant 3 or more - Not payable by MedicareStimulants synthetic - Not payable by MedicareCPT only copyright 2018 American Medical Association. All rights 3403403406
81167MODDESCRIPTIONLABORATORY CERTIFICATION (LC)CODEDrug screening tapentadol - Not payable by MedicareDrug screening tramadol - Not payable by MedicareStereoisomer analysis - Not payable by MedicareDrug/substance nos 1-3 - Not payable by MedicareDrug/substance nos 4-6 - Not payable by MedicareDrug/substance nos 7/more - Not payable by MedicareActh stimulation panelActh stimulation panelActh stimulation panelAldosterone suppression evalCalcitonin stimul panelCRH stimulation panelTestosterone responseEstradiol response panelRenin stimulation panelRenin stimulation panelPituitary evaluation panelDexamethasone panelGlucagon tolerance panelGlucagon tolerance panelGonadotropin hormone panelGrowth hormone panelGrowth hormone panelInsulin suppression panelInsulin tolerance panelInsulin tolerance panelMetyrapone panelTRH stimulation panelTRH stimulation panelUrinalysis, auto, w/o scopeUrinalysisUrine screen for bacteriaUrinalysis test procedureHpa-1 genotypingHpa-2 genotypingHpa-3 genotypingHpa-4 genotypingHpa-5 genotypingHpa-6 genotypingHpa-9 genotypingHpa-15 genotypingIdh1 common variantsIdh2 common variantsDmd dup/delet analysisBrca1&2 seq & full dup/delBrca1&2 gene full seq alys - Effective 1/1/2019Brca1&2 gen ful dup/del alys - Effective 1/1/2019Brca1 gene full seq alys - Effective 1/1/2019Brca1 gene full dup/del alys - Effective 1/1/2019Brca2 gene full dup/del alys - Effective 1/1/2019CPT only copyright 2018 American Medical Association. All rights 0330330330330310, 330310, 330330330310, 330310, 330310, 330310, 0, 310220, 310220, 310220, 310220, 310220, 310220, 310220, 310220, 3107
81228MODDESCRIPTIONAbl1 geneAff2 gene detc abnor alleles - Effective 1/1/2019Aff2 gene charac alleles - Effective 1/1/2019Ar gene full gene sequence - Effective 1/1/2019Ar gene known famil variant - Effective 1/1/2019Asxl1 full gene sequenceAsxl1 gene target seq alysAtn1 gene detc abnor alleles - Effective 1/1/2019Atxn1 gene detc abnor allele - Effective 1/1/2019Atxn2 gene detc abnor allele - Effective 1/1/2019Atxn3 gene detc abnor allele - Effective 1/1/2019Atxn7 gene detc abnor allele - Effective 1/1/2019Atxn8os gen detc abnor allel - Effective 1/1/2019Atxn10 gene detc abnor allel - Effective 1/1/2019Cacna1a gen detc abnor allel - Effective 1/1/2019Cacna1a gene full gene seq - Effective 1/1/2019Cacna1a gen known famil vrnt - Effective 1/1/2019Cnbp gene detc abnor allele - Effective 1/1/2019Cstb gene detc abnor allele - Effective 1/1/2019Cstb gene full gene sequence - Effective 1/1/2019Cstb gene known famil vrnt - Effective 1/1/2019Aspa geneApc gene full sequenceApc gene known fam variantsApc gene dup/delet variantsAr gene charac alleles - Effective 1/1/2019Bckdhb geneBcr/abl1 gene major bpBcr/abl1 gene minor bpBcr/abl1 gene other bpBlm geneBraf geneBrca1&2 seq & com dup/del - Discontinued 12/31/2018Brca1&2 185&5385&6174 varBrca1&2 uncom dup/del var - Discontinued 12/31/2018Brca1 full seq & com dup/del - Discontinued 12/31/2018Brca1 gene known fam variantBrca2 gene full sequenceBrca2 gene known fam variantCebpa gene full sequenceCalr gene com variantsCftr gene com variantsCftr gene known fam variantsCftr gene dup/delet variantsCftr gene full sequenceCftr gene intron poly tCyp2c19 gene com variantsCyp2d6 gene com variantsCyp2c9 gene com variantsCytogen micrarray copy nmbrLABORATORY CERTIFICATION (LC)CODE220, 310, 900220, 310220, 310310, 330310, 330220, 310220, 310220, 310220, 310220, 310220, 310220, 310220, 310220, 310220, 310220, 310220, 310220, 310220, 310220, 310220, 310220, 310220, 310220, 310220, 310310, 330220, 310220, 310, 900220, 310, 900220, 310, 900220, 310220, 310220, 310220, 310220, 310220, 310220, 310220, 310220, 310220, 310, 900220, 310, 900220, 310220, 310220, 310220, 310220, 310220, 310220, 310220, 310220, 310, 900CPT only copyright 2018 American Medical Association. All rights reserved.8
81284MODDESCRIPTIONCytogen m array copy no&snpCyp3a4 gene common variantsCyp3a5 gene common variantsDpyd gene common variantsBtk gene common variants - Effective 1/1/2019Dmpk gene detc abnor allele - Effective 1/1/2019Egfr gene com variantsEzh2 gene full gene sequence - Effective 1/1/2019Ezh2 gene common variants - Effective 1/1/2019F9 full gene sequenceDmpk gene charac alleles - Effective 1/1/2019F2 geneF5 geneFancc geneFmr1 gene detectionFmr1 gene charac allelesFlt3 geneFlt3 gene analysisG6pd gene alys cmn variantG6pd known familial variantG6pd full gene sequenceG6pc geneGba geneGjb2 gene full sequenceGjb2 gene known fam variantsGjb6 gene com variantsHexa geneHfe geneHba1/hba2 geneHba1/hba2 gene fam vrntHba1/hba2 full gene sequenceIkbkap geneIgh gene rearrange amp methIgh gene rearrang dir probeIgh vari regional mutationIgk rearrangeabn clonal popStr markers specimen analStr markers spec anal addlChimerism anal no cell selecChimerism anal w/cell selectHba1/hba2 gene dup/del vrntsJak2 geneHtt gene detc abnor alleles - Effective 1/1/2019Kit gene targeted seq analysKit gene analys d816 variant Htt gene charac alleles - Effective 1/1/2019Kras gene variants exon 2Kras gene addl variantsIfnl3 gene - Effective 1/1/2018Fxn gene detc abnor alleles - Effective 1/1/2019LABORATORY CERTIFICATION (LC)CODE220, 310,
2019 CPT-4 and HCPCS Codes Subject to CLIA Edits cludes non-waived and non-PPMP tests . (12 content and 3 housekeeping genes), utilizing fine needle aspirate or formalin-fixed paraffin-embedded tissue, algorithm reported as risk of metastasis - Effective 1/1/2019 220, 310.
cpt code:11740-2 94.14 cpt code:11750-2 541.06 cpt code:11755-2 123.03 cpt code:11760-2 128.26 cpt code:11762-2 571.07 cpt code:11765-2 581.10 cpt code:11770-2 861.67 cpt code:11771-2 1,092.11 cpt code:11772-2 1,703.29 cpt code:11900-2 56.09 cpt code:11901-2 162.31 cpt code:11920-2 116.23 cpt code
cpt code:11740-2 88.80 cpt code:11750-2 510.36 cpt code:11755-2 116.05 cpt code:11760-2 120.98 cpt code:11762-2 538.68 cpt code:11765-2 548.14 cpt code:11770-2 812.78 cpt code:11771-2 1,030.15 cpt code:11772-2 1,606.65 cpt code:11900-2 52.91 cpt code:11901-2 153.10 cpt code:11920-2 109.63 cpt code
caputo nicholas j cpt sf carr franklin brent cpt lg . dederich david j cpt sf deep alex john cpt sf delew christopher y cpt mi dell jonathan m cpt ar delp jeffrey l cpt lg delre amanda l cpt ad dembeck michael r cpt lg . hefti michael lee
Table of RVU & Conversion Factor values by CPT/HCPCS Codes: CPT/HCPCS: NON-FACILITY; FACILITY ADA: PAY WORK: PE PE: MPE GLOBAL: CONVERSION TERM: SHORT DESCRIPTION HCPCS: MODIFIER STATUS: RVU RVU: RVU RVU: PERIOD FACTOR: DATE (ADA, HCPCS & OWCP codes only; Refer to AMA CPT) 00100 C: 0.00 0.00: 0.00 0.00: XXX 0.00: Anesth Salivary Gland 00102:
Table of RVU & Conversion Factor values by CPT/HCPCS Codes: CPT; NON-FACILITY FACILITY: ADA PAY: WORK PE: PE MPE: GLOBAL CONVERSION: SHORT DESCRIPTION HCPCS: MODIFIER STATUS: RVU RVU: RVU RVU: PERIOD FACTOR: END DATE (ADA, HCPCS & OWCP codes only; Refer to AMA CPT) 00100 C: 0.00 0.00: 0.00 0.00: XXX 0.00: Anesth Salivary Gland 00102:
CPT 93922 and CPT 93923 can be requested and reported only once for the upper extremities and once for the lower extremities. CPT 93922 and CPT 93923 should not be ordered on the same request nor billed together for the same date of service. CPT 93924 and CPT 93922 and/or CPT 93923 should not be ordered on the same request and should not be billed together for the same date
CPT 15823 Blepharoplasty, upper eyelid; with excessive skin weighting down lid CPT 19318. Reduction mammaplasty CPT 19324 Mammaplasty, augmentation; without prosthetic implant CPT 19325. Mammaplasty, augmentation; with prosthetic implant CPT 20550 Injection(s); single tendon sheath, or ligament, aponeurosis (e.g., plantar "fascia") CPT 20551
review of optometry novartis percept . 2020 icd-9-cm 2020 cpt 2020 hcpcs 2020 icd-10-cm meetings & journals. reference books. . used since october 1, 2015—if you are still using icd -9, wtf? cpt level i codes (created by the ama cpt editorial panel) hcpcs (cpt level ii) carrier determination .
