Medicaid Fee Schedule without Mods 200801

More documents

Recommendations

Info

PROC-CODE DESC MAC BEG END 58152 TOTAL HYSTERECTOMY (CORPUS AND CERVIX), WITH OR WITHOUT REMOVAL $764.59 20060701 99999999 58180 SUPRACERVICAL HYSTERECTOMY (SUBTOTAL HYSTERECTOMY), WITH OR $710.45 20060701 99999999 58200 TOTAL HYSTERECTOMY, INCLUDING PARTIAL VAGINECTOMY, WITH LIMITED $991.85 20060701 99999999 58210 RADICAL HYSTERECTOMY, WITH BILATERAL TOTAL PELVIC AND LIMITED $1,320.62 20060701 99999999 58240 PELVIC EXENTERATION FOR GYNECOLOGIC MALIGNANCY, WITH $1,849.01 20060701 99999999 58260 VAGINAL HYSTERECTOMY $591.29 20060701 99999999 58262 VAGINAL HYSTERECTOMY; WITH REMOVAL OF TUBE(S), AND/OR OVARY(S) $652.63 20060701 99999999 58263 VAGINAL HYSTERECTOMY; WITH REMOVAL OF TUBE(S), AND/OR OVARY(S), WITH REPAIR OF E $712.17 20060701 99999999 58267 VAGINAL HYSTERECTOMY $722.94 20060701 99999999 58270 VAGINAL HYSTERECTOMY $650.62 20060701 99999999 58275 VAGINAL HYSTERECTOMY, WITH TOTAL OR PARTIAL COLPECTOMY $714.50 20060701 99999999 58280 VAGINAL HYSTERECTOMY, WITH TOTAL OR PARTIAL COLPECTOMY $720.14 20060701 99999999 58285 VAGINAL HYSTERECTOMY, RADICAL (SCHAUTA TYPE OPERATION) $864.51 20060701 99999999 58290 VAGINAL HYSTERECTOMY, FOR UTERUS GREATER THAN 250 GRAMS; $807.83 20060701 99999999 58291 VAGINAL HYSTERECTOMY, FOR UTERUS GREATER THAN 250 GRAMS; WITH REMOVAL OF TUBE(S) $888.17 20060701 99999999 58292 VAGINAL HYSTERECTOMY, FOR UTERUS GREATER THAN 250 GRAMS; WITH REMOVAL OF TUBE(S) $940.29 20060701 99999999 58293 VAGINAL HYSTERECTOMY, FOR UTERUS GREATER THAN 250 GRAMS; WITH COLPO-URETHROCYSTO $977.19 20060701 99999999 58294 VAGINAL HYSTERECTOMY, FOR UTERUS GREATER THAN 250 GRAMS; WITH REPAIR OF ENTEROCE $866.46 20060701 99999999 58300 INSERTION OF INTRAUTERINE DEVICE (IUD) $51.59 19990701 99999999 58301 REMOVAL OF INTRAUTERINE DEVICE (IUD) $47.15 20060701 99999999 58321 ARTIFICIAL INSEMINATION; INTRA-CERVICAL $43.74 20030401 99999999 58322 ARTIFICIAL INSEMINATION; INTRA-UTERINE $49.67 20030401 99999999 58323 SPERM WASHING FOR ARTIFICIAL INSEMINATION $10.61 20030401 99999999 58340 INJECTION PROCEDURE FOR HYSTEROSALPINGOGRAPHY $38.69 20060701 99999999 58345 TRANSCERVICAL INTRODUCTION OF FALLOPIAN TUBE CATHETER FOR DIAGNOSIS AND/OR RE-ES $213.03 20060701 99999999 58346 INSERTION OF HEYMAN CAPSULES FOR CLINICAL BRACHYTHERAPY $302.67 20060701 99999999 58350 HYDROTUBATION OF OVIDUCT, INCLUDING MATERIALS $56.65 20060701 99999999 58353 ENDOMETRIAL ABLATION, THERMAL, WITHOUT HYSTEROSCOPIC GUIDANCE $167.34 20060701 99999999 58356 ENDOMETRIAL CRYOABLATION WITH ULTRASONIC GUIDANCE, INCLUDING ENDOMETRIAL $272.46 20060701 99999999 58400 UTERINE SUSPENSION, WITH OR WITHOUT SHORTENING OF ROUND $334.02 20060701 99999999 58410 UTERINE SUSPENSION, WITH OR WITHOUT SHORTENING OF ROUND $551.60 20060701 99999999 58520 HYSTERORRHAPHY, REPAIR OF RUPTURED UTERUS (NONOBSTETRICAL) $503.86 20060701 99999999 58540 HYSTEROPLASTY, REPAIR OF UTERINE ANOMALY (STRASSMAN TYPE) $610.80 20060701 99999999 58541 LAPAROSCOPY, SURGICAL, SUPRACERVICAL HYSTERECTOMY, FOR UTERUS 250 G OR LESS; $565.62 20070101 99999999 58542 LAPAROSCOPY, SURGICAL, SUPRACERVICAL HYSTERECTOMY, FOR UTERUS 250 G OR LESS; WIT $625.98 20070101 99999999 58543 LAPAROSCOPY, SURGICAL, SUPRACERVICAL HYSTERECTOMY, FOR UTERUS GREATER THAN 250 G $636.34 20070101 99999999 58544 LAPAROSCOPY, SURGICAL, SUPRACERVICAL HYSTERECTOMY, FOR UTERUS GREATER THAN 250 G $688.37 20070101 99999999 Hawaii Medicaid Fee Schedule without Mods 01/2008 200
PROC-CODE DESC MAC BEG END 58545 LAPAROSCOPY, SURGICAL, MYOMECTOMY, EXCISION; 1 TO 4 INTRAMURAL MYOMAS WITH TOTAL $648.58 20060701 99999999 58546 LAPAROSCOPY, SURGICAL, MYOMECTOMY, EXCISION; 5 OR MORE INTRAMURAL MYOMAS AND/OR $818.05 20060701 99999999 58548 LAPAROSCOPY, SURGICAL, WITH RADICAL HYSTERECTOMY, WITH BILATERAL TOTAL PELVIC LY $1,203.89 20070101 99999999 58550 LAPAROSCOPY, SURGICAL; WITH VAGINAL HYSTERECTOMY WITH OR WITHOUT REMOVAL OF TUBE $659.77 20060701 99999999 58551 LAPAROSCOPY, SURGICAL; WITH REMOVAL OF LEIOMYOMATA (SINGLE OR MULTIPLE) $582.41 20000101 99999999 58552 LAPAROSCOPY SURGICAL, WITH VAGINAL HYSTERECTOMY, FOR UTERUS 250 GRAMS OR LESS; W $631.57 20060701 99999999 58553 LAPAROSCOPY, SURGICAL, WITH VAGINAL HYSTERECTOMY, FOR UTERUS GREATER THAN 250 GR $813.79 20060701 99999999 58554 LAPAROSCOPY, SURGICAL, WITH VAGINAL HYSTERECTOMY, FOR UTERUS GREATER THAN 250 GR $806.59 20060701 99999999 58555 HYSTEROSCOPY, DIAGNOSTIC (SEPARATE PROCEDURE) $147.79 20060701 99999999 58558 HYSTEROSCOPY, SURGICAL; WITH SAMPLING (BIOPSY) OF ENDOMETRIUM AND/OR POLYPECTOMY $215.73 20060701 99999999 58559 HYSTEROSCOPY, SURGICAL; WITH LYSIS OF INTRAUTERINE ADHESIONS (ANY METHOD) $275.75 20060701 99999999 58560 HYSTEROSCOPY, SURGICAL; WITH DIVISION OR RESECTION OF INTRAUTERINE SEPTUM (ANY M $304.09 20060701 99999999 58561 HYSTEROSCOPY, SURGICAL; WITH REMOVAL OF LEIOMYOMATA $426.54 20060701 99999999 58562 HYSTEROSCOPY, SURGICAL; WITH REMOVAL OF IMPACTED FOREIGN BODY $212.31 20060701 99999999 58563 HYSTEROSCOPY, SURGICAL; WITH ENDOMETRIAL ABLATION (ANY METHOD) $285.73 20060701 99999999 58565 HYSTEROSCOPY, SURGICAL; WITH BILATERAL FALLOPIAN TUBE CANNULATION TO INDUCE $336.69 20060701 99999999 58570 LAPAROSCOPY, SURGICAL, WITH TOTAL HYSTERECTOMY, FOR UTERUS 250 G OR LESS; $460.67 20080101 99999999 58571 LAPAROSCOPY, SURGICAL, WITH TOTAL HYSTERECTOMY, FOR UTERUS 250 G OR LESS; WITH R $504.43 20080101 99999999 58572 LAPAROSCOPY, SURGICAL, WITH TOTAL HYSTERECTOMY, FOR UTERUS GREATER THAN 250 G; $570.28 20080101 99999999 58573 LAPAROSCOPY, SURGICAL, WITH TOTAL HYSTERECTOMY, FOR UTERUS GREATER THAN 250 G; W $643.31 20080101 99999999 58600 LIGATION OR TRANSECTION OF FALLOPIAN TUBE(S), ABDOMINAL OR VAGINAL $224.12 20060701 99999999 58605 LIGATION OR TRANSECTION OF FALLOPIAN TUBE(S), ABDOMINAL OR VAGINAL $203.59 20060701 99999999 58611 LIGATION OR TRANSECTION OF FALLOPIAN TUBE(S) WHEN DONE AT THE TIME OF $29.69 19990701 99999999 58615 OCCLUSION OF FALLOPIAN TUBE(S) BY DEVICE (EG, BAND, CLIP, FALOPE RING) $205.58 20060701 99999999 58660 LAPAROSCOPY, SURGICAL; WITH LYSIS OF ADHESIONS (SALPINGOLYSIS, OVARIOLYSIS) (SEP $500.64 20060701 99999999 58661 LAPAROSCOPY, SURGICAL; WITH REMOVAL OF ADNEXAL STRUCTURES (PARTIAL OR TOTAL OOPH $510.94 20060701 99999999 58662 LAPAROSCOPY, SURGICAL; WITH FULGURATION OR EXCISION OF LESIONS OF THE OVARY, PEL $508.46 20060701 99999999 58670 LAPAROSCOPY, SURGICAL; WITH FULGURATION OF OVIDUCTS (WITH OR WITHOUT TRANSECTION $288.81 20060701 99999999 58671 LAPAROSCOPY, SURGICAL; WITH OCCLUSION OF OVIDUCTS BY DEVICE (EG, BAND, CLIP, OR $298.17 20060701 99999999 58672 LAPAROSCOPY, SURGICAL; WITH FIMBRIOPLASTY $548.34 20060701 99999999 Hawaii Medicaid Fee Schedule without Mods 01/2008 201
Page 1 and 2:
PROC-CODE DESC MAC BEG END A0130 NO
Page 3 and 4:
PROC-CODE DESC MAC BEG END A4355 3-
Page 5 and 6:
PROC-CODE DESC MAC BEG END A4431 OS
Page 7 and 8:
PROC-CODE DESC MAC BEG END A5093 OS
Page 9 and 10:
PROC-CODE DESC MAC BEG END A6231 GA
Page 11 and 12:
PROC-CODE DESC MAC BEG END A6452 HI
Page 13 and 14:
PROC-CODE DESC MAC BEG END A7504 FI
Page 15 and 16:
PROC-CODE DESC MAC BEG END ENTERAL
Page 17 and 18:
PROC-CODE DESC MAC BEG END D4210 GI
Page 19 and 20:
PROC-CODE DESC MAC BEG END D7911 SU
Page 21 and 22:
PROC-CODE DESC MAC BEG END E0248 TR
Page 23 and 24:
PROC-CODE DESC MAC BEG END E0580 NE
Page 25 and 26:
PROC-CODE DESC MAC BEG END E0911 TR
Page 27 and 28:
PROC-CODE DESC MAC BEG END E1085 HE
Page 29 and 30:
PROC-CODE DESC MAC BEG END E1638 HE
Page 31 and 32:
PROC-CODE DESC MAC BEG END E2324 PO
Page 33 and 34:
PROC-CODE DESC MAC BEG END E2605 PO
Page 35 and 36:
PROC-CODE DESC MAC BEG END G0091 IN
Page 37 and 38:
PROC-CODE DESC MAC BEG END G0206 DI
Page 39 and 40:
PROC-CODE DESC MAC BEG END K0032 SE
Page 41 and 42:
PROC-CODE DESC MAC BEG END K0130 FO
Page 43 and 44:
PROC-CODE DESC MAC BEG END K0240 HY
Page 45 and 46:
PROC-CODE DESC MAC BEG END K0529 ST
Page 47 and 48:
PROC-CODE DESC MAC BEG END K0822 PO
Page 49 and 50:
PROC-CODE DESC MAC BEG END L0350 TL
Page 51 and 52:
PROC-CODE DESC MAC BEG END L0633 LU
Page 53 and 54:
PROC-CODE DESC MAC BEG END L1685 HO
Page 55 and 56:
PROC-CODE DESC MAC BEG END L2106 AF
Page 57 and 58:
PROC-CODE DESC MAC BEG END L2670 AD
Page 59 and 60:
PROC-CODE DESC MAC BEG END L3420 FU
Page 61 and 62:
PROC-CODE DESC MAC BEG END L3906 WH
Page 63 and 64:
PROC-CODE DESC MAC BEG END L4110 RE
Page 65 and 66:
PROC-CODE DESC MAC BEG END L5622 AD
Page 67 and 68:
PROC-CODE DESC MAC BEG END L5701 AL
Page 69 and 70:
PROC-CODE DESC MAC BEG END L5981 AL
Page 71 and 72:
PROC-CODE DESC MAC BEG END L6646 UP
Page 73 and 74:
PROC-CODE DESC MAC BEG END L6915 HA
Page 75 and 76:
PROC-CODE DESC MAC BEG END L8170 EL
Page 77 and 78:
PROC-CODE DESC MAC BEG END M0728 EX
Page 79 and 80:
PROC-CODE DESC MAC BEG END Q4047 CA
Page 81 and 82:
PROC-CODE DESC MAC BEG END V2522 CO
Page 83 and 84:
PROC-CODE DESC MAC BEG END W9801 QU
Page 85 and 86:
PROC-CODE DESC MAC BEG END 00530 AN
Page 87 and 88:
Page 89 and 90:
Page 91 and 92:
Page 93 and 94:
Page 95 and 96:
PROC-CODE DESC MAC BEG END 11443 EX
Page 97 and 98:
PROC-CODE DESC MAC BEG END 12056 LA
Page 99 and 100:
PROC-CODE DESC MAC BEG END 15341 TI
Page 101 and 102:
Page 103 and 104:
PROC-CODE DESC MAC BEG END 19110 NI
Page 105 and 106:
PROC-CODE DESC MAC BEG END 20612 AS
Page 107 and 108:
PROC-CODE DESC MAC BEG END 21100 AP
Page 109 and 110:
PROC-CODE DESC MAC BEG END 21310 TR
Page 111 and 112:
PROC-CODE DESC MAC BEG END 21920 BI
Page 113 and 114:
PROC-CODE DESC MAC BEG END 22844 PO
Page 115 and 116:
Page 117 and 118:
Page 119 and 120:
PROC-CODE DESC MAC BEG END 25316 FL
Page 121 and 122:
PROC-CODE DESC MAC BEG END 26010 DR
Page 123 and 124:
PROC-CODE DESC MAC BEG END 26530 AR
Page 125 and 126:
Page 127 and 128:
Page 129 and 130:
PROC-CODE DESC MAC BEG END 27513 OP
Page 131 and 132:
Page 133 and 134:
PROC-CODE DESC MAC BEG END 28200 RE
Page 135 and 136:
PROC-CODE DESC MAC BEG END 28636 PE
Page 137 and 138:
Page 139 and 140:
PROC-CODE DESC MAC BEG END 30801 CA
Page 141 and 142:
PROC-CODE DESC MAC BEG END 31560 LA
Page 143 and 144:
PROC-CODE DESC MAC BEG END 32310 PL
Page 145 and 146:
Page 147 and 148:
Page 149 and 150: PROC-CODE DESC MAC BEG END 33647 RE
Page 153 and 154: PROC-CODE DESC MAC BEG END 35102 DI
Page 155 and 156: PROC-CODE DESC MAC BEG END TRANSLUM
Page 159 and 160: PROC-CODE DESC MAC BEG END 36555 IN
Page 161 and 162: PROC-CODE DESC MAC BEG END 37188 PE
Page 163 and 164: PROC-CODE DESC MAC BEG END 38570 LA
Page 165 and 166: PROC-CODE DESC MAC BEG END 41114 EX
Page 167 and 168: PROC-CODE DESC MAC BEG END 42836 AD
Page 169 and 170: PROC-CODE DESC MAC BEG END 43260 EN
Page 175 and 176: PROC-CODE DESC MAC BEG END 45114 PR
Page 177 and 178: PROC-CODE DESC MAC BEG END 46221 HE
Page 181 and 182: PROC-CODE DESC MAC BEG END 48511 EX
Page 187 and 188: PROC-CODE DESC MAC BEG END 50940 DE
Page 189 and 190: PROC-CODE DESC MAC BEG END 51920 CL
Page 191 and 192: PROC-CODE DESC MAC BEG END 52647 NO
Page 193 and 194: PROC-CODE DESC MAC BEG END 54162 LY
Page 195 and 196: PROC-CODE DESC MAC BEG END 55110 SC
Page 197 and 198: PROC-CODE DESC MAC BEG END 56353 HY
Page 199: PROC-CODE DESC MAC BEG END 57310 CL
Page 203 and 204: PROC-CODE DESC MAC BEG END 59070 TR
Page 205 and 206: PROC-CODE DESC MAC BEG END 61026 VE
Page 207 and 208: PROC-CODE DESC MAC BEG END 61576 TR
Page 209 and 210: PROC-CODE DESC MAC BEG END 61865 CR
Page 211 and 212: PROC-CODE DESC MAC BEG END 62360 IM
Page 217 and 218: PROC-CODE DESC MAC BEG END 64837 SU
Page 219 and 220: PROC-CODE DESC MAC BEG END 65870 SE
Page 221 and 222: PROC-CODE DESC MAC BEG END 67225 DE
Page 223 and 224: PROC-CODE DESC MAC BEG END 68320 CO
Page 225 and 226: PROC-CODE DESC MAC BEG END 69643 TY
Page 227 and 228: PROC-CODE DESC MAC BEG END 70542 MA
Page 229 and 230: PROC-CODE DESC MAC BEG END 72200 RA
Page 233 and 234: PROC-CODE DESC MAC BEG END 75822 VE
Page 237 and 238: PROC-CODE DESC MAC BEG END 76938 UL
Page 241 and 242: PROC-CODE DESC MAC BEG END 78261 GA
Page 245 and 246: PROC-CODE DESC MAC BEG END 82000 AC
Page 247 and 248: PROC-CODE DESC MAC BEG END 82533 CO
Page 249 and 250: PROC-CODE DESC MAC BEG END 83015 HE
Page 251 and 252:
PROC-CODE DESC MAC BEG END 83903 MO
Page 253 and 254:
PROC-CODE DESC MAC BEG END 84425 TH
Page 255 and 256:
PROC-CODE DESC MAC BEG END 85370 FI
Page 257 and 258:
PROC-CODE DESC MAC BEG END 86343 LE
Page 259 and 260:
Page 261 and 262:
PROC-CODE DESC MAC BEG END 87206 SM
Page 263 and 264:
PROC-CODE DESC MAC BEG END 87471 IN
Page 265 and 266:
Page 267 and 268:
PROC-CODE DESC MAC BEG END 88184 FL
Page 269 and 270:
PROC-CODE DESC MAC BEG END 89140 GA
Page 271 and 272:
PROC-CODE DESC MAC BEG END 90734 ME
Page 273 and 274:
PROC-CODE DESC MAC BEG END 90847 FA
Page 275 and 276:
PROC-CODE DESC MAC BEG END 92250 OP
Page 277 and 278:
PROC-CODE DESC MAC BEG END 92602 DI
Page 279 and 280:
PROC-CODE DESC MAC BEG END 93237 EL
Page 281 and 282:
Page 283 and 284:
PROC-CODE DESC MAC BEG END 94016 PA
Page 285 and 286:
PROC-CODE DESC MAC BEG END 95811 PO
Page 287 and 288:
PROC-CODE DESC MAC BEG END 96000 CO
Page 289 and 290:
PROC-CODE DESC MAC BEG END 97022 PH
Page 291 and 292:
PROC-CODE DESC MAC BEG END 99214 OF
Page 293 and 294:
PROC-CODE DESC MAC BEG END 99307 SU
Page 295:
PROC-CODE DESC MAC BEG END 99440 NE
show all

Medicaid Fee Schedule without Mods 200801

Create successful ePaper yourself

Delete template?

Save as template?