Medicine and Surgery Section - Wisconsin.gov
Medicine and Surgery Section - Wisconsin.gov
Medicine and Surgery Section - Wisconsin.gov
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Appendix<br />
<strong>Surgery</strong> Services<br />
Appendix 1<br />
(Continued)<br />
Service CPT Procedure Code(s)<br />
Allowable<br />
Modifier(s)<br />
General 10021-10022<br />
Integumentary System 10040-19499<br />
Musculoskeletal System 20000-29999<br />
Respiratory System 30000-32999<br />
Cardiovascular System 33010-37799<br />
Hemic <strong>and</strong> Lymphatic Systems 38100-38999<br />
Mediastinum <strong>and</strong> Diaphragm 39000-39599<br />
Digestive System 40490-49999<br />
Urinary System 50010-51720<br />
51725-51797<br />
51798-53899<br />
TC, 26<br />
Male Genital System 54000-54235<br />
54240, 54250<br />
54300-55899<br />
TC, 26<br />
Female Genital System 56405-58999<br />
Maternity Care <strong>and</strong> Delivery 59000-59899<br />
Endocrine System 60000-60699<br />
Nervous System 61000-62230<br />
62252<br />
62256-62365<br />
TC, 26<br />
62367, 62368<br />
63001-64999<br />
26<br />
Eye <strong>and</strong> Ocular Adnexa 65091-66983<br />
66820-66821, 66830-66984<br />
66985-68899<br />
54, 55<br />
Auditory System 69000-69979<br />
Radiology Services<br />
Refer to the Laboratory <strong>and</strong> Radiology section of this h<strong>and</strong>book for Medicaid-covered radiology services (CPT codes 70010-<br />
79999 <strong>and</strong> HCPCS codes).<br />
Laboratory Services<br />
Refer to the Laboratory <strong>and</strong> Radiology section of this h<strong>and</strong>book for Medicaid-covered laboratory services (CPT codes 80048-<br />
89356 <strong>and</strong> HCPCS).<br />
68 <strong>Wisconsin</strong> Medicaid <strong>and</strong> BadgerCare dhfs.wisconsin.<strong>gov</strong>/medicaid/ December 2005