(AFP) CPT CODE - Stormont-Vail HealthCare

Revised July 2003* The policies for these tests give guidelines for allowed frequency of testing. Most are not definitive but aredependent on the patient’s diagnoses. It is important to remember the following simplified guidelines.Blood Glucose .....................................................................................Not more than every 3 monthsGlycated Hemoglobin ........................................................................Not more than every 3 monthsLipid Panel ..........................................................................................AnnuallyDirect LDL or Total Cholesterol for Monitoring Treatment ......Up to 6 times per yearThyroid Testing Up to 2 times per year for patients with normal thyroid functionAlpha-fetoprotein (AFP) CPT CODE: 82105ICD-9-CM Codes Covered by Medicare Program:Code:Description:070.22-070.23 Chronic viral hepatitis B with hepatic coma, with or without mention of hepatitis delta070.32-070.33 Chronic viral hepatitis B without mention of hepatic coma, with or without mention of hepatitisdelta070.44 Chronic hepatitis C with hepatic coma070.54 Chronic hepatitis C without mention of hepatic coma095.3 Syphilis of liver121.1 Clonorchiasis121.3 Fascioliasis155.0-155.2 Malignant neoplasm of the liver and intrahepatic bile ducts164.2-164.9 Malignant neoplasm of the mediastinum183.0 Malignant neoplasm, ovary186.0 Malignant neoplasm of undescended testis186.9 Malignant neoplasm, other and unspecific testis197.1 Secondary malignant neoplasm of mediastinum197.7 Secondary malignant neoplasm of liver198.6 Secondary malignant neoplasm of ovary198.82 Secondary malignant neoplasm, genital organs211.5 Benign neoplasm of liver and biliary passages235.3 Neoplasm of uncertain behavior of liver and biliary passages272.2 Mixed hyperlipidemia275.0 Disorder of iron metabolites275.1 Disorder of copper metabolism277.00 Cystic Fibrosis without mention of meconium ileus277.03 Cystic fibrosis with gastrointestinal manifestations277.6 Other deficiencies of circulating enzymes285.0 Sideroblastic Anemia571.2 Alcoholic cirrhosis of liver571.40 Chronic hepatitis, unspecified571.41 Chronic persistent hepatitis571.49 Other chronic hepatitis571.5 Cirrhosis of liver without mention of alcohol608.89 Other specified disorders of male genital organs793.1 Non-specific abnormal findings of lung field793.2 Non-specific abnormal findings of other intrathoracic organs793.3 Non-specific abnormal findings of biliary tract793.6 Non-specific abnormal findings of abdominal area, including retro peritoneumV10.07 Personal history of malignant neoplasm, liverV10.43 Personal history of malignant neoplasm, ovaryV10.47 Personal history of malignant neoplasm, testis2

Bladder Tumor Antigen CPT CODE: 86294ICD-9-CM Codes Covered by Medicare Program:Code:Description:188.0 Malignant neoplasm of bladder; trigone of urinary bladder188.1 Malignant neoplasm of bladder; dome of urinary bladder188.2 Malignant neoplasm of bladder; lateral wall of urinary bladder188.3 Malignant neoplasm of bladder; anterior wall of urinary bladder188.4 Malignant neoplasm of bladder; posterior wall of urinary bladder188.5 Malignant neoplasm of bladder; bladder neck188.6 Malignant neoplasm of bladder; ureteric orifice188.7 Malignant neoplasm of bladder; urachus188.8 Malignant neoplasm of bladder; other specified sites of bladder188.9 Malignant neoplasm of bladder; bladder, part unspecified198.1 Secondary malignant neoplasm of other specified parts; other urinary organs233.7 Carcinoma in situ of breast and genitourinary system; bladder239.4 Neoplasms of unspecified nature; bladder599.7 Other disorders of urethra and urinary tract; hematuriaV10.51 Personal history of malignant neoplasm; urinary organs, bladderV10.53 Personal history of malignant neoplasm; urinary organs, renal pelvisV67.2 Follow-up examination following chemotherapy3

Blood CountsTest NameCPT CodeCBC (CBC) - 85025CBC Without Diff (CBCND) - 85027Hematocrit (CRIT) - 85014Hemoglobin (HGB) - 85018Eosinophil Count (EO-CT) - 85048Platelet Count (PLTCT) - 85049CPT CODES: 85004 85007 8500885013 85014 85018 85025 8502785032 85048 85049The ICD-9 CM Codes COVERED by Medicare for Blood Counts are anycodes NOT LISTED in EITHER of the ICD-9 CM code sections listed below.ICD-9-CM Codes DENIED:Code:Description:798.0 - 798.9 Sudden infant death syndromeV15.85 Personal history of exposure to potentially hazardous body fluidsV16.1 Family history of malignant neoplasm of trachea, bronchus, and lungV16.2 Family history of malignant neoplasm of other respiratory and intrathoracic organsV16.40 Family history of malignant neoplasm of genital organ unspecifiedV16.51-V16.59 Family history of malignant neoplasm of kidneyV16.6 Family history of leukemiaV16.7 Family history of other lymphatic and hematopoietic neoplasmsV16.8 Family history of other specified malignant neoplasmV16.9 Family history of unspecified malignant neoplasmV17.0 - V17.8 Family history of psychiatric conditionV18.0 - V18.8 Family history of diabetes mellitusV19.0 - V19.8 Family history of blindness or visual lossV20.0 - V20.2 Health supervision of foundlingV28.0 - V28.9 Antenatal screening for chromosomal anomalies by amniocentesisV50.0 - V50.9 Elective hair transplant for purposes other than remedying health statesV53.2 Fitting and adjustment of hearing aidV60.0 - V60.9 Lack of housingV62.0 UnemploymentV62.1 Adverse effects of work environmentV65.0 Healthy persons accompanying sick personsV65.1 Persons consulting on behalf of another personV68.0 - V68.9 Issue of medical certificatesV70.0 - V70.9 Routine general medical examination at a health care facilityV73.0 - V73.99 Screening examination for poliomyelitisV74.0 - V74.9 Screening examination for choleraV75.0 - V75.9 Screening examination for rickettsial diseasesV76.0 Special screening for malignant neoplasms of the respiratory organsV76.3 Screening for malignant neoplasms of the bladderV76.42 - V76.9 Screening for malignant neoplasms of the oral cavityV77.0 - V77.99 Screening for thyroid disordersV78.0 - V78.9 Screening for iron deficiency anemiaV79.0 - V79.9 Screening for depressionV80.0 - V80.3 Screening for neurological conditionsV81.0 - V81.6 Screening for ischemic heart diseaseV82.0 - V82.9 Screening for skin conditions4

ICD-9-CM Codes That DO NOT Support Medical Necessity:Code:Description:078.10-078.19 Viral warts210.0-210.9 Benign neoplasm of lip, oral cavity, and pharynx214.0 Lipoma, skin and subcutaneous tissue of face216.0-216.9 Benign neoplasm of skin217 Benign neoplasm of breast222.0-222.9 Benign neoplasm of male genital organs224.0 Benign neoplasm of eyeball, except conjunctiva, cornea, retina, and choroid230.0 Carcinoma in situ of lip, oral cavity and pharynx232.0-232.9 Carcinoma in situ of skin300.00-300.09 Neurotic disorders301.0-301.9 Personality disorders302.0-302.9 Sexual deviations and disorders307.0 Stammering and stuttering307.20-307.23 Tics307.3 Stereotyped repetitive movements307.80-307.89 Psychalgia312.00-312.9 Disturbance of conduct, not elsewhere classified313.0-313.9 Disturbance of emotions specific to childhood and adolescence314.00-314.9 Hyperkinetic syndrome of childhood363.30-363.35 Chorioretinal scars363.40-363.43 Choroidal degeneration363.50-363.57 Hereditary choroidal dystrophies363.70-363.9 Choroidal detachment366.00-366.9 Cataract367.0-367.9 Disorders of refraction and accommodation371.00-371.9 Corneal opacity and oother disorders of cornea373.00-373.9 Inflammation of eyelids375.00-375.9 Disorders of lacrimal system376.21-376.22 Disorders of the orbit376.4 - 376.9 Disorders of the orbit377.10-377.16 Optic atrophy377.21-377.24 Other disorders of optic disc384.20-384.25 Perforation of tympanic membrane384.81-384.82 Other specified disorders of tympanic membrane385.00-385.9 Other disorders of middle ear and mastoid387.0-387.9 Otosclerosis388.00-388.5 Other disorders of ear389.00-389.9 Hearing loss440.0-440.1 Atherosclerosis of aorta and renal artery443.81-443.9 Other and unspecified peripheral vascular disease448.1 Capillary nevus, non neoplastic457.0 Postmastectomy lymphedema syndrome470 Deviated nasal septum471.0-471.9 Nasal polyps478.0 Hypertrophy of nasal turbinates478.4 Polyp of vocal cord or larynx520.0-520.9 Disorders of tooth development and eruption521.00-521.9 Diseases of hard tissues of teeth524.00-524.9 Dentofacial anomalies, including malocclusion5

Code:Description:525.0-525.9 Other diseases and conditions of teeth and supporting structures526.0-526.3 Diseases of the jaws527.6-527.9 Diseases of salivary glands575.6 Cholesterolosis of gallbladder6

ICD-9-CM Codes That DO NOT Support Medical Necessity:600.0-600.9 Hyperplasia of prostate603.0 Encysted hydrocele603.8 Other specified types of hydrocele603.9 Hydrocele, unspecified605 Redundant prepuce and phimosis606.0-606.1 Infertility, male azoospermia and oligospremia608.1 Spermatocele608.3 Atrophy of testis610.0-610.9 Benign mammary dysplasia611.1-611.6 Other disorders of breast611.9 Unspecified breast disorder616.2 Cyst of Bartholin's gland618.0-618.9 Genital prolapse620.0-620.3 Noninflammatory disorders of ovary, fallopian tube, and broad ligament621.6-621.7 Malposition or chronic inversion of uterus627.2-627.9 Menopausal and post menopausal disorders628.0-628.9 Infertility, female676.00-676.94 Other disorders of breast associated with childbirth and disorders of lactation691.0-691.8 Atopic dermatitis and related disorders692.0-692.9 Contact dermatitis and other eczema700 Corns and callosities701.0-701.9 Other hypertrophic and atrophic conditions of skin702.0-702.8 Other dermatoses703.9 Unspecified disease of nail706.0-706.9 Diseases of sebaceous glands709.00-709.4 Other disorders of skin and subcutaneous tissue715.00-715.98 Osteoarthrosis716.00-716.99 Other and unspecified arthropathies718.00-718.99 Other derangement of joint726.0-726.91 Peripheral enthesopathies and allied syndromes727.00-727.9 Other disorders of synovium, tendon, and bursa728.10-728.85 Disorders of muscle ligament and fascia732.0-732.9 Osteochondropathies733.00-733.09 Osteoporosis734 Flat foot735.0-735.9 Acquired deformities of toe736.00-736.9 Other acquired deformities of limb737.0-737.9 Curvature of spine738.0-738.9 Other acquired deformity739.0-739.9 Nonallopathic lesions, not elsewhere classified830.0-839.9 Dislocations840.0-848.9 Sprains and strains of joints and adjacent muscles905.0-909.9 Late effects of musculoskeletal and connective tissue injuries910.0-919.9 Superficial injuries930.0-932 Foreign body on external eye, in ear, in nose955.0-957.9 Injury to peripheral nerveV03.0-V06.9 Need for prophylactic vaccinationV11.0-V11.9 Personal history of mental disorderV14.0-V14.8 Personal history of allergy to medicinal agentsV16.0 Family history of malignant neoplasm, gastrointestinal tractV16.3 Family history of malignant neoplasm, breast7

V21.0-V21.9V25.01-V25.9V26.0-V26.9Constitutional states in developmentEncounter for contraceptive managementProcreative management8

ICD-9-CM Codes That DO NOT Support Medical Necessity:V40.0-V40.9 Mental and behavioral problemsV41.0-V41.9 Problems with special senses and other special functionsV43.0-V43.1 Organ or tissue replaced by other means, eye globe or lensV44.0-V44.9 Artificial opening statusV45.00-V45.89 Other post surgical statesV48.0-V48.9 Problems with head, neck, and trunkV49.0-V49.9 Other conditions influencing health statusV51Aftercare involving the use of plastic surgeryV52.0-V52.9 Fitting and adjustment of prosthetic device and implantV53.01-V53.09 Fitting and adjustment of devices related to nervous system and special sensesV53.1 Fitting and adjustment of spectacles and contact lensesV53.31-V53.39 Fitting and adjustment of cardiac deviceV53.4 Fitting and adjustment of orthodontic devicesV53.5 Fitting and adjustment of other intestinal applianceV53.6 Fitting and adjustment of urinary devicesV53.7 Fitting and adjustment of orthopedic devicesV53.8 Fitting and adjustment of wheelchairV53.9 Fitting and adjustment of other and unspecified deviceV54.0-V54.9 Other orthopedic aftercareV54.10-v54.17 Aftercare for healing traumatic fractureV54.19 Aftercare for healing traumatic fracture of other boneV54.20-V54.27 Aftercare for healing pathologic fractureV54.29 Aftercare for healing pathologic fracture of other boneV54.81 Aftercare following joint replacementV54.89 Other orthopedic aftercareV55.0-V55.9 Attention to artificial openingsV57.0-V57.9 Care involving use of rehabilitation proceduresV58.5 OrthodonticsV59.01 Whole blood donorsV59.02 Stem cell blood donorsV59.09 Other blood donorsV59.1-V59.9 DonorsV61.0-V61.9 Other family circumstancesV62.2-V62.9 Other psychosocial circumstancesV65.2 Person feigning illnessV65.3 Dietary surveillance and counselingV65.40-V65.49 Other counseling, not elsewhere classifiedV65.5 Person with feared complaint in whom no diagnosis was madeV65.8 Other reasons for seeking consultationV65.9 Unspecified reason for consultationV66.0-V66.9 Convalescence and palliative careV67.3 Follow-up examination following psychotherapyV67.4 Follow-up examination following treatment of healed fractureV69.3 Problems related to lifestyle, gambling and bettingV71.01-V71.09 Observation and evaluation for suspected conditions not found, mentalV72.0-V72.2 Special investigations, examination of eyes and vision, ears and hearing, dentalV72.4-V72.7 Special investigations, preganancy exam, radiologic exam, laboratory exam, diagnostic skin andsensitization testsV72.9 Special investigation, unspecifiedV76.10-V76.19 Special screening for malignant neoplasms, breastV76.2 Special screening for malignant neoplasms, cervix9

Blood Glucose TestingCPT CODE: 82947 82948 82962(Glustx)ICD-9-CM Codes Covered by Medicare Program:Code:Description:011.00-011.96 Tuberculosis of lung infiltrative confirmation unspecified038.0-038.9 Streptococcal septicemia112.1 Candidiasis of vulva and vagina112.3 Candidiasis of skin and nails118 Opportunistic mycoses157.4 Malignant neoplasm of Islets of Langerhans158.0 Malignant neoplasm of retroperitoneum211.7 Benign neoplasm of Islets of Langerhans242.00-242.91 Toxic diffuse goiter without thyrotoxic crisis or storm250.00-250.93 Diabetes mellitus without complication type II or unspecified type not stated as uncontrolled251.0-251.9 Hypoglycemic coma253.0-253.9 Acromegaly and gigantism255.0 Cushing’s syndrome263.0-263.9 Malnutrition of moderate degree271.0-271.9 Glycogenosis272.0-272.4 Pure hypercholestrolemia275.0 Disorders of iron metabolism276.0-276.9 Hyperosmolality and/or hypernatremia278.3 Hypercarotinemia293.0 Acute delirium294.9 Unspecified organic brain syndrome (chronic)298.9 Unspecified psychosis300.9 Unspecified neurotic disorder310.1 Organic personality syndrome337.9 Unspecified disorder of autonomic nervous system345.10-345.11 Generalized convulsive epilepsy without intractable epilepsy348.3 Encephalopathy, unspecified355.9 Monomeuritis of unspecified site356.9 Unspecified idiopathic peripheral neuropathy357.9 Unspecified inflammatory and toxic neuropathies362.10 Background retinopathy unspecified362.18 Retinal vasculitis362.29 Other nondiabetic proliferative retinopathy362.50-362.57 Macular degeneration (senile) of retina unspecified362.60-362.66 Peripheral retinal degeneration unspecified362.81-362.89 Retinal hemorrhage362.9 Unspecified retinal disorder365.04 Ocular hypertension365.32 Corticosteroid-induced glaucoma residual stage366.00-366.09 Nonsenile cataract unspecified366.10-366.19 Senile cataract unspecified367.1 Myopia368.8 Other specified visual disturbance373.00 Blepharitis unspecified11

Code:Description:377.24 Pseudopapilledema377.9 Unspecified disorder of optic nerve and visual pathways378.50-378.55 Paralytic strabismus unspecified379.45 Argyll-Robertson pupil atypical410.00-410.92 Acute myocardial infarction of anterolateral wall episode of care unspecified414.00-414.19 Coronary atherosclerosis of unspecified type of vessel native or graft425.9 Secondary cardiomyopathy, unspecified440.23 Arteriosclerosis of native arteries of the extremities with ulceration440.24 Arteriosclerosis of native arteries of the extremities with gangrene440.9 Generalized and unspecified arteriosclerosis458.0 Orthostatic hypotension462 Acute pharyngitis466.0 Acute bronchitis480.0-486 Pneumonia due to adenovirus490 Bronchitis, not specified as acute or chronic491.0-491.9 Simple chronic bronchitis527.7 Disturbance of salivary secretion528.0 Stomatitis535.50-535.51 Unspecified gastritis and gastroduodenitis (without hemorrhage)536.8 Dyspepsia and other specified disorders of function of stomach571.8 Other chronic nonalcoholic liver disease572.0-572.8 Abscess of liver574.50-574.51 Calculus of bile duct without cholecystitis without obstruction575.0-575.12 Acute cholecystitis576.1 Cholangitis577.0 Acute pancreatitis577.1 Chronic pancreatitis577.8 Other specified diseases of pancreas590.00-590.9 Chronic pyelonephritis without lesion of renal medullary necrosis595.9 Cystitis unspecified596.4 Atony of bladder596.53 Paralysis of bladder599.0 Urinary tract infection site not specified607.84 Impotence of organic origin608.89 Other specified disorders male genital organs616.10 Vaginitis and vulvovaginitis unspecified626.0 Absence of menstruation626.4 Irregular menstrual cycle628.9 Infertility female of unspecified origin648.00 Diabetes mellitus of mother complicating pregnancy, childbirth or the puerperium, unspecified as toepisode of care648.03 Antepartum diabetes mellitus648.04 Postpartum diabetes mellitus648.80 Abnormal glucose tolerance of mother complicating pregnancy, childbirth or the puerperium,unspecified as to episode of care648.83 Abnormal glucose tolerance of mother antepartum648.84 Abnormal glucose tolerance of mother postpartum656.60-656.63 Excessive fetal growth affecting management of mother unspecified as to episode of care657.00-657.03 Polyhydramnios unspecified as to episode of care680.0-680.9 Carbuncle and furuncle of face686.00-686.9 Pyoderma unspecified698.0 Pruritus ani698.1 Pruritus of genital organs12

Code:Description:704.1 Hirsutism705.0 Anhidrosis707.0-707.9 Decubitus ulcer709.3 Degenerative skin disorders729.1 Myalgia and myositis unspecified730.07 Acute osteomyelitis involving ankle and foot730.17 Chronic osteomyelitis involving ankle and foot730.27 Unspecified osteomyelitis involving ankle and foot780.01 Coma780.02 Transient alteration of awareness780.09 Alteration of consciousness, other780.2 Syncope and collapse780.31 Febrile convulsions780.39 Other convulsions780.4 Dizziness and giddiness780.71-780.79 Chronic fatigue syndrome780.8 Hyperhidrosis781.0 Abnormal involuntary movements782.0 Disturbance of skin sensation783.1 Abnormal weight gain783.21 Loss of weight783.5 Polydipsia783.6 Polyphagia785.0 Tachycardia unspecified785.4 Gangrene786.01 Hyperventilation786.09 Respiratory abnormality other786.50 Unspecified chest pain787.6 Incontinence of feces787.91 Diarrhea788.41-788.43 Urinary frequency789.1 Hepatomegaly790.2 Abnormal glucose tolerance test790.6 Other abnormal blood chemistry791.0 Proteinuria791.5 Glycosuria796.1 Abnormal reflex799.4 CachexiaV23.0-V23.9 Supervision of high risk pregnancy with history of infertilityV58.69 Long term (current) use of other medicationV67.2 Follow-up examination following chemotherapyV67.51 Follow up examination following completed treatment with high-risk medication not elsewhereclassified13

Carcinoembryonic Antigen (CEA) CPT CODE: 82378ICD-9-CM Codes Covered by Medicare Program:Code:Description:150.0-150.9 Malignant neoplasm of the esophagus151.0-151.9 Malignant neoplasm of stomach152.0-154.8 Malignant neoplasm of small intestine, including duodenum, rectum, rectosigmoid junction andanus.157.0-157.9 Primary malignancy of pancreas159.0 Malignant neoplasm of intestinal tract, part unspecified162.0-162.9 Malignant neoplasm of trachea, bronchus, lung174.0-174.9 Malignant neoplasm of female breast175.0-175.9 Malignant neoplasm of male breast183.0 Malignant neoplasm of ovary197.0 Secondary malignant neoplasm of neoplasm of lung197.4 Secondary malignant neoplasm of small intestine197.5 Secondary malignant neoplasm of large intestine and rectum230.3 Carcinoma in situ of colon230.4 Carcinoma in situ of rectum230.7 Carcinoma in situ of other/unspecified parts of intestine230.9 Carcinoma in situ other and unspecified digestive organs235.2 Neoplasm of uncertain behavior of stomach, intestines, rectum790.99 Other nonspecific findings on examination of bloodV10.00 Personal history of malignant neoplasm of gastro-intestinal tract, unspecifiedV10.05 Personal history of malignant neoplasm, large intestineV10.06 Personal history of malignant neoplasm, rectum, rectosigmoid junction, anusV10.11 Personal history of malignant neoplasm, bronchus, and lungV10.3 Personal history of malignant neoplasm, breastV10.43 Personal history of malignant neoplasm, ovaryV67.2 Follow-up examination following chemotherapy14

Collagen Crosslinks, Any CPT CODE: 82523ICD-9-CM Codes Covered by Medicare Program:Code:Description:242.00-242.91 Thyrotoxicosis245.2 Chronic lymphocytic thyroiditis (only if thyrotoxic)246.9 Unspecified disorder of thyroid252.0 Hyperparathyroidism256.2 Postablative ovarian failure256.31-256.39 Other ovarian failure256.8 Other ovarian dysfunction256.9 Unspecified ovarian dysfunction268.9 Unspecified vitamin D deficiency269.3 Mineral deficiency, not elsewhere classified627.0 Premenopausal menorrhagia627.1 Postmenopausal bleeding627.2 Symptomatic menopausal or female climacteric state627.4 Symptomatic states associated with artificial menopause627.8 Other specified menopausal and postmenopausal disorders627.9 Unspecified menopausal & postmenopausal disorder731.0 Osteitis deformans without mention of bone tumor (Paget’s disease of bone)733.00-733.09 Osteoporosis733.10-733.19 Pathological fracture733.90 Disorder of bone and cartilage, unspecified805.8 Fracture of vertebral column without mention of spiral cord injury, unspecified, closedV58.69 Long-term (current) use of other Medications15

Culture, Bacterial, Urine, andSensitivityCPT CODES: 87086 87088 8718487186(URINC)ICD-9-CM Codes Covered by Medicare ProgramCode:Description:003.1 Salmonella septicemia038.0-038.9 Septicemia276.2 Acidosis276.4 Metabolic acidosis/alkalosis286.6 Defibrination syndrome/disseminated intravascular coagulation288.0 Agranulocytosis/neutropenia288.8 Other specified disease of white blood cells including leukemoid reaction/leukocytosis306.53 Psychogenic dysuria306.59 Other psychogenic genitourinary malfunction518.82 Other pulmonary insufficiency, not elsewhere classified570 Acute and subacute necrosis of liver580.0-580.9 Acute glomerulonephritis583.0-583.9 Nephritis and Nephropathy, not specified as acute or chronic584.5 Acute renal failure, with lesion of tubular necrosis584.9 Acute renal failure, unspecified585 Chronic renal failure586 Renal failure, unspecified590.00-590.9 Infections of kidney/pyelonephritis acute and chronic592.0-592.9 Calculus of kidney and ureter593.0-593.9 Other disorders of kidney and ureter (cyst, stricture, obstruction, reflux, etc.)594.0-594.9 Calculus of lower urinary tract595.0-595.9 Cystitis597.0 Urethritis, not sexually transmitted and urethral syndrome597.80-597.89 Other urethritis598.00-598.01 Urethral stricture due to infection599.0 Urinary tract infection, site not specified599.7 Hematuria600.0-600.9 Hyperplasia of prostate601.0-601.9 Inflammatory diseases of prostate602.0-602.9 Other disorders of prostate (calculus, congestion, atrophy, etc.)604.0-604.99 Orchitis and epididymitis608.0-608.9 Other disorders of male genital organs (seminal vesiculitis, spermatocele, etc.)614.0-614.9 Inflammatory disease of ovary, fallopian tube, pelvic cellular tissue, and peritoneum615.0-615.9 Inflammatory disease of uterus, except cervix616.0 Cervicitis and endocervicitis616.10-616.11 Vaginitis and vulvovaginitis616.2-616.9 Other inflammatory conditions of cervix, vagina and vulva619.0-619.9 Fistula involving female genital tract625.6 Stress incontinence, female639.0 Genital tract and pelvic infection complicating abortion, ectopic or molar pregnancies639.5 Shock complicating abortion, ectopic or molar pregnancies646.60-646.64 Infections of genitourinary tract in pregnancy670.00-670.04 Major puerperal infection672.00-672.04 Pyrexia of unknown origin during the puerperium16

Code:Description:724.5 Backache, unspecified771.81 Septicemia (sepsis) of newborn771.82 Urinary tract infection of newborn771.83 Bacteremia of newborn780.02 General symptoms, transient alteration of awareness780.6 Fever (Hyperthermia)780.79 Other malaise and fatigue780.99 Other general symptoms785.0 Tachycardia, unspecified785.50-785.59 Shock without mention of trauma788.0-788.9 Symptoms involving urinary system (renal colic, dysuria, retention of urine, incontinence of urine,frequency, polyuria, nocturia, oliguria, anuria, other abnormality of urination, urethral discharge,extravasation of urine, other symptoms of urinary system)789.00-789.09 Abdominal pain789.60-789.69 Abdominal tenderness790.7 Bacteremia791.0-791.9 Nonspecific findings on examination of urine (proteinuria, chyluria, hemoglobinuria,myoglobinuria, biliuria, glycosuria, acetonuria, other cells and casts in urine, other nonspecificfindings on examination of urine)799.3 Debility, unspecified (only for declining functional status)939.0 Foreign body in genitourinary tract, bladder and urethra939.3 Foreign body in genitourinary tract, penisV44.50-V44.6 Artificial cystostomy or other artificial opening of urinary tract statusV55.5-V55.6 Attention to cystostomy or other artificial opening of urinary tractV58.69 Long-term (current) use of other medicationsV72.84 Pre-operative examination, unspecified17

Digoxin Therapeutic Drug Assay(DIG)CPT CODE: 80162ICD-9-CM Codes Covered by Medicare Program:Code:Description:242.00-242.91 Thyrotoxicosis with or without goiter243 Congenital hypothyroidism244.0-244.9 Acquired hypothyroidism245.0-245.9 Thyroiditis275.2 Disorders of magnesium metabolism275.40-275.49 Disorders of calcium metabolism276.0 Hyperosmolality276.1 Hyposmolality276.2 Acidosis276.3 Alkalosis276.4 Mixed acid-base balance disorder276.5 Volume depletion276.6 Fluid Overload276.7 Hyperpotassemia276.8 Hypopotassemia276.9 Electrolyte and fluid Disorder (not elsewhere classified)293.0 Acute delirium293.1 Subacute delirium307.47 Other dysfunctions of sleep stages or arousal from sleep368.16 Psychophysical visual disturbances368.8 Other specified visual disturbances368.9 Unspecified visual disturbances397.9 Rheumatic diseases of endocardium398.0 Rheumatic Myocarditis398.91 Rheumatic Heart Failure402.01 Hypertensive heart disease, malignant with heart failure402.11 Hypertensive heart disease, benign with heart failure402.91 Hypertensive heart disease, unspecified with heart failure403.00-403.91 Hypertensive renal disease404.00-404.93 Hypertensive heart & renal disease410.00-410.92 Acute myocardial infarction411.0-411.89 Other acute & subacute forms of ischemic heart disease413.0-413.9 Angina pectoris422.0-422.99 Acute myocarditis425.0-425.9 Cardiomyopathy426.0-426.9 Conduction disorders427.0-427.9 Cardiac dysrhythmias428.0-428.9 Heart failure429.2 Cardiovascular disease, unspecified429.4 Heart Disturbances Postcardiac Surgery429.5 Rupture chordae tendineae429.6 Rupture papillary muscle429.71 Acquired cardiac septal defect514 Pulmonary congestion & hypostasis579.9 Unspecified Intestinal malabsorption18

Code:Description:584.5-584.9 Acute renal failure585 Chronic renal failure586 Renal Failure, unspecified587 Renal sclerosis, unspecified588.0 Renal osteodystrophy588.1 Nephrogenic Diabetes Insipidus588.8 Impaired renal function (not elsewhere classified)588.9 Unspecified disorder resulting from impaired renal function780.01 Coma780.02 Transient alteration of awareness780.09 Other ill-defined general symptoms (drowsiness, semicoma, somnolence, stupor, unconsciousness)780.1 Hallucinations780.2 Syncope & collapse780.4 Dizziness and giddiness780.71-780.79 Malaise & fatigue783.0 Anorexia784.0 Headache787.01-787.03 Nausea & vomiting787.91 Diarrhea794.31 Abnormal electrocardiogram799.2 Nervousness972.0 Poisoning by cardiac rhythm regulators972.1 Poisoning by cardiotonic glycosides & drugs of similar action995.2 Unspecified adverse effect of drug, medicinal and biological substance*E942.1Adverse effect of cardiotonic glycosides and drugs of similar actionV58.69 Encounter long term - Medication Use (not elsewhere classified)* Code may not be reported as a stand-alone or first-listed code on the claim.19

Fecal Occult Blood (OCCBL) CPT CODE: 82270ICD-9-CM Codes Covered by Medicare Program:Code:Description:003.0 Salmonella gastroenteritis003.1 Salmonella septicemia004.0-004.9 Shigellosis005.0-005.9 Other food poisoning (bacterial)006.0-006.9 Amebiasis007.0-007.9 Other protozoal intestinal diseases008.41-008.49 Intestinal infections due to other specified bacteria009.0-009.3 Ill-defined intestinal infections014.00-014.86 Tuberculosis of intestines, peritoneum, and mesenteric glands040.2 Whipple’s disease095.2 Syphilitic peritonitis095.3 Syphilis of liver098.0 Gonococcal infection, acute, lower genitourinary tract098.7 Gonococcal Infection anus and rectum098.84 Gonococcal endocaritis123.0-123.9 Other cestode infection124 Trichinosis127.0-127.9 Other intestinal helminthiases139.8 Late effects of other and unspecified infectious and parasitic diseases150.0-157.9 Malignant neoplasm of digestive organisms159.0-159.9 Malignant neoplasm of other and illdefined sites within the digestive organs and peritoneum176.3 Kaposi’s sarcoma, gastrointestinal sites197.4-197.5 Secondary malignant neoplasm of intestines197.8 Secondary malignant neoplasm of other digestive organs and spleen199.0 Disseminated malignant neoplasm204.00-204.91 Lymphoid leukemia205.00-208.91 Leukemia211.0-211.9 Benign neoplasm of other parts of digestive system228.04 Hemangioma of intra-abdominal structures230.2-230.9 Carcinoma in situ of digestive organs235.2 Neoplasm of uncertain behavior of stomach, intestines, and rectum235.5 Neoplasm of uncertain behavior of other and unspecified digestive organs239.0 Neoplasm of unspecified nature, digestive system280.0-280.9 Iron deficiency anemias285.0-285.9 Other and unspecified anemias286.0-286.9 Coagulation defects287.0-287.9 Purpura and other hemorrhagic conditions448.0 Hereditary hemorrhagic telangiectasia455.0-455.8 Hemorrhoids456.0-456.21 Esophageal varices with or without mention of bleeding530.10-535.61 Diseases of the esophagus, stomach, and duodenum536.2 Persistent vomiting536.8-536.9 Dyspepsia and other specified and unspecified functional disorders of the stomach537.0-537.4 Other disorders of stomach and duodenum537.82-537.83 Angiodysplasia of stomach and duodenum537.84 Dieulafoy lesion (hemorrhagic) of stomach and duodenum537.89 Other specified disorders of stomach and duodenum20

Code:Description:555.0-558.9 Non-infectious enteritis and colitis560.0-560.39 Intestinal obstruction/impaction without mention of hernia562.10-562.13 Diverticulosis/diverticulitis of colon564.00-564.9 Functional digestive disorders, not elsewhere classified565.0-565.1 Anal fissure and fistula569.0 Anal and rectal polyp569.1 Rectal prolapse569.3 Hemorrhage of rectum and anus569.41-569.49 Other specified disorders of rectum and anus569.82-569.83 Ulceration and perforation of intestine569.84-569.85 Angiodysplasia of intestine with or without mention of hemorrhage569.86 Dieulafoy lesion (hemorrhagic) of intestine571.0-571.9 Chronic liver disease and cirrhosis577.0-577.9 Diseases of the pancreas578.0-578.9 Gastrointestinal hemorrhage579.0 Celiac disease579.8 Other specified intestinal malabsorption596.1 Intestinovesical fistula617.5 Endometriosis of intestine780.71 Chronic fatigue syndrome780.79 Other malaise and fatigue783.0 Anorexia783.21 Abnormal loss of weight787.01-787.03 Nausea and vomiting787.1 Heartburn787.2 Dysphagia787.7 Abnormal feces787.91 Diarrhea787.99 Other symptoms involving digestive system789.00-789.09 Abdominal pain789.30-789.39 Abdominal or pelvic swelling, mass, or lump789.40-789.49 Abdominal rigidity789.5 Ascites789.60-789.69 Abdominal tenderness790.92 Abnormal coagulation profile792.1 Nonspecific abnormal findings in stool contents793.6 Nonspecific abnormal findings on radiological and other794.8 Nonspecific abnormal results of function studies, liver863.0-863.90 Injury to gastrointestinal tract864.00-864.09 Injury to liver without mention of open wound into cavity864.11-864.19 Injury to liver with open wound into cavity866.00-866.03 Injury to kidney without mention of open wound into cavity866.10-866.13 Injury to kidney with open wound into cavity902.0 -902.9 Injury to blood vessels of abdomen and pelvis926.11-926.19 Crushing injury of trunk, other specified sites926.8 Crushing injury of trunk, multiple sites926.9 Crushing injury of trunk, unspecified site964.2 Poisoning by agents primarily affecting blood constituents, anticoagulants995.2 Unspecified adverse effect of drug, medicinal, and biological substanceV10.00-V10.09 Personal history of malignant neoplasm, gastrointestinal tractV12.00 Personal history of unspecified infectious and parasitic diseaseV12.72 Personal history of colonic polypsV58.61 Long term (current) use of anticoagulants21

Code:Description:V58.69 Long term (current) use of other medicationsV67.51 Following treatment with high risk medication, not elsewhere specified22

Gamma Glutamyl Transferase (GGT) CPT CODE: 82977ICD-9-CM Codes Covered by Medicare Program:Code:Description:003.1 Salmonella septicemia006.0-006.9 Amebiasis014.00-014.86 Tuberculosis of intestines, peritoneum, and mesenteric glands017.90-017.96 Tuberculosis of other specified organs018.90-018.96 Miliary tuberculosis, unspecified020.0-020.9 Plague022.3 Anthrax septicemia027.0 Listeriosis027.1 Erysipelothrix infection030.1 Tuberculoid leprosy [Type T]032.83 Diphtheritic peritonitis036.1 Meningococcal encephalitis036.2 Meningococcemia038.0-038.9 Septicemia039.2 Actinomycotic infections, abdominal040.0 Gas gangrene042 Human immunodeficiency virus (HIV) disease054.0 Eczema herpeticum054.5 Herpetic septicemia060.0-060.1 Yellow fever070.0-070.9 Viral hepatitis072.71 Mumps hepatitis073.0 Ornithosis, with pneumonia074.8 Other specified diseases due to Coxsackie virus075 Infectious mononucleosis078.5 Cytomegaloviral disease079.99 Unspecified viral infection082.0-082.9 Tick-borne rickettsioses, stet084.9 Other pernicious complications of malaria086.1 Chagas disease with organ involvement other than heart088.81 Lyme disease091.62 Secondary syphilitic hepatitis095.3 Syphilis of liver100.0 Leptospirosis icterohemorrhagica112.5 Candidiasis, disseminated115.00 Infection by Histoplasma capsulatum without mention of manifestation120.9 Schistosomiasis, unspecified121.1 Clonorchiasis121.3 Fascioliasis122.0 Echinococcus granulosus infection of liver122.5 Echinococcus multilocularis infection of liver122.8 Echinococcosis, unspecified, of liver122.9 Echinococcus, other and unspecified130.5 Hepatitis due to toxoplasmosis135 Sarcoidosis150.0-159.9 Malignant neoplasm of digestive organs and peritoneum160.0-165.9 Malignant neoplasm of respiratory and intrathoracic organs23

Code:Description:170.0-176.9 Malignant neoplasm of bone, connective tissue, skin, and breast179-189.9 Malignant neoplasm of genitourinary organs200.00-208.91 Malignant neoplasm of lymphatic and hematopoietic tissue211.5 Benign neoplasm of liver and biliary passages211.6 Benign neoplasm of pancreas, except islets of Langerhans211.7 Benign neoplasm of islets of Langerhans228.04 Hemangioma of intra-abdominal structures230.7 Carcinoma in situ of other and unspecified parts of intestine230.8 Carcinoma in situ of liver and biliary system230.9 Carcinoma in situ other and unspecified digestive organs235.0-238.9 Neoplasms of uncertain behavior239.0 Neoplasm of unspecified nature of digestive system250.00-250.93 Diabetes mellitus252.0 Hyperparathyroidism263.1 Malnutrition of mild degree263.9 Unspecified protein-calorie malnutrition268.0 Rickets, active268.2 Osteomalacia, unspecified269.0 Deficiency of vitamin K270.2 Other disturbances of aromatic amino acid metabolism270.9 Unspecified disorder of amino acid metabolism271.0 Glycogenosis272.0 Pure hypercholesterolemia272.1 Pure hyperglyceridemia272.2 Mixed hyperlipidemia272.4 Other and unspecified hyperlipidemia272.7 Lipidoses272.9 Unspecified disorder of lipoid metabolism275.0 Disorders of iron metabolism275.1 Disorders of copper metabolism275.3 Disorders of phosphorus metabolism275.40-275.49 Disorders of calcium metabolism277.1 Disorders of porphyrin metabolism277.3 Amyloidosis277.4 Disorders of bilirubin excretion277.6 Other deficiencies of circulating enzymes282.60-282.69 Sickle cell anemia286.6 Defibrination syndrome286.7 Acquired coagulation factor deficiency289.4 Hypersplenism291.0-291.9 Alcoholic psychoses303.00-303.03 Acute alcoholic intoxication303.90-303.93 Other and unspecified alcohol dependence304.00-304.93 Drug dependence305.00-305.93 Non-dependent abuse of drugs357.5 Alcoholic polyneuropathy359.2 Myotonic disorders452 Portal vein thrombosis453.0-453.9 Other vein embolism and thrombosis456.0-456.21 Esophageal varices555.0-555.9 Regional enteritis556.0-556.9 Ulcerative colitis557.0 Acute vascular insufficiency of intestine24

Code:Description:558.1-558.9 Other noninfectious gastroenteritis and colitis560.0-560.9 Intestinal obstruction without mention of hernia562.01 Diverticulitis of small intestine (without mention of hemorrhage)562.03 Diverticulitis of small intestine with hemorrhage562.11 Diverticulitis of colon (without mention of hemorrhage)562.13 Diverticulitis of colon with hemorrhage567.0-567.9 Peritonitis569.83 Perforation of intestine570 Acute and subacute necrosis of liver571.0-571.9 Chronic liver disease and cirrhosis572.0-572.8 Liver abscess and sequelae of chronic liver disease573.0-573.9 Other disorders of liver574.00-574.91 Cholelithiasis575.0-575.9 Other disorders of gallbladder576.0-576.9 Other disorders of biliary tract581.0-581.9 Nephrotic syndrome582.0-582.9 Chronic glomerulonephritis583.0-583.9 Nephritis and nephropathy not specified as acute or chronic584.5-584.9 Acute renal failure585 Chronic renal failure586 Renal failure, unspecified587 Renal sclerosis, unspecified588.0-588.9 Disorders resulting from impaired renal function590.00-590.9 Infections of kidney642.50-642.54 Severe pre-eclampsia646.70, 646.71, Liver disorders in pregnancy646.73782.4 Jaundice, unspecified, not of newborn789.1 Hepatomegaly790.4 Nonspecific elevation of levels of transaminase or lactic acid dehydrogenase790.5 Other nonspecific abnormal serum enzyme levels960.0-979.9 Poisoning by drugs, medicinal, and biological substances980.0-989.89 Toxic effects of substances chiefly nonmedicinal as to sourceV42.7 Organ replaced by transplant, liverV58.61-V58.69 Long term (current) drug useV67.1 Follow-up examination, radiotherapyV67.2 Follow-up examination, chemotherapyV67.51 Follow-up examination after completed treatment with high-risk medications, not elsewhereclassified25

Glycated Hemoglobin/ Glycated Protein(A1C)CPT CODES: 8303682985ICD-9-CM Codes Covered by The Medicare Program:Code:Description:211.7 Benign neoplasm of islets of Langerhans250.00-250.93 Diabetes mellitus & various related codes251.0 Hypoglycemic coma251.1 Other specified hypoglycemia251.2 Hypoglycemia unspecified251.3 Post-surgical hypoinsulinemia251.4 Abnormality of secretion of glucagon251.8 Other specified disorders of pancreatic internal secretion251.9 Unspecified disorder of pancreatic internal secretion258.0-258.9 Polyglandular dysfunction271.4 Renal glycosuria275.0 Hemochromatosis577.1 Chronic pancreatitis579.3 Other and unspecified postsurgical nonabsorption648.00 Diabetes mellitus complicating pregnancy, Childbirth or the puerperium, unspecified as to episodeof care or not applicable648.03 Diabetes mellitus complicating pregnancy, Childbirth or the puerperium, antepartum condition orcomplication648.04 Diabetes mellitus complicating pregnancy, Childbirth or the puerperium, postpartum condition orcomplication648.80 Abnormal glucose tolerance complicating pregnancy, childbirth or the puerperium, unspecified as toepisode of care or not applicable648.83 Abnormal glucose tolerance complicating pregnancy, childbirth or the puerperium, antepartumcondition or complication648.84 Abnormal glucose tolerance complicating pregnancy, childbirth or the puerperium, postpartumcondition or complication790.2 Abnormal glucose tolerance test790.6 Other abnormal blood chemistry (hyperglycemia)962.3 Poisoning by insulin and antidiabetic agentsV12.2 Personal history of endocrine, metabolic, and immunity disordersV58.69 Long-term use of other medication26

Hepatitis Panel/ Acute Hepatitis Panel(HEP-1)CPT CODE: 80074This panel consists of the following tests:Hepatitis B surface antigen (HBsAg) (CPT 87340)Hepatitis C antibody (CPT 86803)Hepatitis B core antibody (HBcAb), IgM Antibody (CPT 86705)Hepatitis A antibody (HAAb), IgM Antibody (CPT 86709)ICD-9-CM Codes Covered by Medicare Program:Code:Description:070.0-070.9 Viral hepatitis456.0-456.21 Esophageal varices with or without mention of bleeding570 Acute and subacute necrosis of liver571.5 Cirrhosis of liver without mention of alcohol572.0-572.8 Liver abscess and sequelae of chronic liver disease573.3 Hepatitis, unspecified780.31 Febrile convulsions780.71 Chronic fatigue syndrome780.79 Other malaise and fatigue782.4 Jaundice, unspecified, not of newborn783.0-783.6 Symptoms concerning nutrition, metabolism, and development784.69 Other symbolic dysfunction787.01-787.03 Nausea and vomiting789.00-789.09 Abdominal pain789.1 Hepatomegaly789.61 Localized abdominal tenderness (RUQ)794.8 Nonspecific abnormal results of function996.82 Complications of transplanted organ, liver999.3 Other infection following infusion, injection, transfusion, or vaccinationV72.85 Liver transplant recipient evaluation27

Human Chorionic Gonadotropin (HCG) CPT CODE: 84702ICD-9-CM Codes Covered by Medicare Program:Code:Description:158.0 Malignant neoplasm of retroperitoneum158.8 Malignant neoplasm of specified parts of peritoneum164.2 Malignant neoplasm of anterior mediastinum164.3 Malignant neoplasm of posterior mediastinum164.8 Malignant neoplasm, other (includes malignant neoplasm of contiguous overlapping sites of thymus,heart, and mediastinum whose point of origin cannot be determined164.9 Malignant neoplasm of mediastinum, part specified181 Malignant neoplasm of placenta183.0 Malignant neoplasm of ovary183.8 Other specified sites of uterine adnexa186.0 Malignant neoplasm of undescended testis186.9 Malignant neoplasm of other and unspecified testis194.4 Malignant neoplasm of pineal gland197.1 Secondary malignant neoplasm of mediastinum197.6 Secondary malignant neoplasm of retroperitoneum and peritoneum198.6 Secondary malignant neoplasm of ovary198.82 Secondary malignant neoplasm of other genital organs236.1 Neoplasm of uncertain behavior, placenta623.8 Vaginal bleeding625.9 Pelvic pain630 Hydatidiform mole631 Pregnancy, molar632 Missed abortion633.90-633.91 Unspecified ectopic pregnancy634.00-634.02 Spontaneous abortion, complicated by genital tract and pelvic infection640.00-640.03 Threatened abortion642.30-642.34 Transient hypertension of pregnancy642.40-642.74 Pre-eclampsia or eclampsia642.90-642.94 Unspecified hypertension complicating pregnancy, childbirth, or the puerperiumV10.09 Personal history of malignant neoplasm, other gastrointestinal sitesV10.29 Personal history of malignant neoplasm of other respiratory and intrathoracic organsV10.43 Personal history of malignant neoplasm, ovaryV10.47 Personal history of malignant neoplasm, testisV22.0-V22.1 Normal pregnancy28

Human ImmunodeficiencyVirus Testing (Diagnosis)CPT CODES: 86689 86701 8670286703 87390 87391 87534 8753587537 87538Other Names/Abbreviations: HIV, HIV-1, HIV-2, HIV1/2, HTLV III, Human T-cell lymphotropic virus, AIDS,Acquired immune deficiency syndromeICD-9-CM Codes Covered by Medicare Program:Code:Description:003.1 Salmonella septicemia007.2 Coccidiosis (Isoporiasis)007.4 Cryptosporidiosis007.8 Other specified protozoal intestinal diseases010.00-010.96 Primary tuberculous infection011.00-011.96 Pulmonary tuberculosis012.00-012.86 Other respiratory tuberculosis013.00-013.96 Tuberculosis of meninges and central nervous system014.00-014.86 Tuberculosis of intestines, peritoneum and mesenteric glands015.00-015.96 Tuberculosis of bones and joints016.00-016.96 Tuberculosis of genitourinary system017.00-017.96 Tuberculosis of other organs018.00-018.96 Miliary tuberculosis027.0 Listeriosis031.0-031.9 Diseases due to other mycobacteria038.2 Pneumococcal septicemia038.43 Septicemia (Pseudomonas)039.0-039.9 Actinomycotic infections (includes Nocardia)041.7 Pseudomonas infection042 HIV disease (Acute retroviral syndrome, AIDS-related complex)046.3 Progressive multifocal leukoencephalopathy049.0-049.9 Other non-arthropod-borne viral diseases of central nervous system052.0-052.8 Chickenpox (with complication)053.0-053.9 Herpes zoster054.0-054.9 Herpes simplex055.0-055.8 Measles (with complication)070.20-070.23 Viral hepatitis B with hepatic coma070.30-070.33 Viral hepatitis B without mention of hepatic coma070.41 Acute or unspecified hepatitis C with hepatic coma070.42 Hepatitis delta without mention of active hepatitis B disease with hepatic coma070.44 Chronic hepatitis C with hepatic coma070.49 Other specified viral hepatitis with hepatic coma070.51 Acute or unspecified hepatitis C without hepatic coma070.52 Hepatitis delta without mention of active hepatitis B disease without hepatic coma070.54 Chronic hepatitis C without hepatic coma070.59 Other specified viral hepatitis without hepatic coma070.6 Unspecified viral hepatitis with hepatic coma070.9 Unspecified viral hepatitis without hepatic coma078.0 Molluscum contagiosum078.10-078.19 Viral warts078.3 Cat-scratch disease078.5 Cytomegaloviral disease078.88 Other specified diseases due to Chlamydiae29

Code:Description:079.50 Retrovirus unspecified079.51 HTLV-I079.52 HTLV-II079.53 Human immunodeficiency virus, type 2079.59 Other specified Retrovirus079.88 Other specified chlamydial infection079.98 Unspecified chlamydial infection085.0-085.9 Leishmaniasis088.0 Bartonellosis090.0-090.9 Congenital syphilis091.0-091.9 Early syphilis symptomatic092.0-092.9 Early syphilis, latent093.0-093.9 Cardiovascular syphilis094.0-094.9 Neurosyphilis095.0-095.9 Other forms of late syphilis, with symptoms096 Late syphilis, latent097.0-097.9 Other and unspecified syphilis098.0-098.89 Gonococcal infections099.0 Chancroid099.1 Lymphogranuloma venereum099.2 Granuloma inguinale099.3 Reiter’s disease099.40-099.49 Other nongonococcal urethritis099.50-099.59 Other venereal diseases due to Chlamydia trachomatis099.8 Other specified venereal diseases099.9 Veneral disease, unspecified110.1 Dermatophytosis of nail111.0 ityriasis versicolor112.0-112.9 Candidiasis114.0-114.9 Coccidioidomycosis115.00-115.99 Histoplasmosis116.0-116.2 Blastomycotic infection117.3 Aspergillosis117.5 Cryptococcosis118 Opportunistic mycoses127.2 Strongyloidiasis130.0-130.9 Toxoplasmosis131.01 Trichomonal vulvovaginitis132.2 Phthirus pubis133.0 Scabies136.2 Specific infections by free living amebae136.3 Pneumocystosis136.8 Other specified infectious and parasitic disease (for example, microsporidiosis)176.0-176.9 Kaposi’s sarcoma180.0-180.9 Malignant neoplasm of cervix uteri200.20-200.28 Burkitt’s tumor or lymphoma200.80-200.88 Lymphosarcoma, other named variants201.00-201.98 Hodgkin’s disease263.0 Malnutrition of moderate degree263.1 Malnutrition of mild degree263.9 Unspecified protein-calorie malnutrition280.0-280.9 Iron deficiency anemias285.9 Anemia, unspecified30

Code:Description:287.3 Primary thrombocytopenia288.0 Agranulocytosis288.8 Other specified disease of white blood cells294.8 Other specified organic brain syndromes (chronic)310.1 Organic personality syndrome322.2 Chronic meningitis336.9 Unspecified disease of spinal cord348.3 Encephalopathy unspecified354.0-354.9 Mononeuritis of upper limbs and mononeuritis multiplex356.8 Other specified idiopathic peripheral neuropathy363.20 Chorioretinitis, unspecified425.4 Other primary cardiomyopathies473.0-473.9 Chronic sinusitis481-482.9 Pneumococcal pneumonia484.1 Pneumonia in cytomegalic inclusion disease486 Pneumonia, organism unspecified512.8 Other spontaneous pneumothorax516.8 Other specified alveolar and parietoalveolar pneumonopathies528.2 Oral aphthae528.6 Leukoplakia of oral mucosa530.2 Ulcer of esophagus583.9 Nephropathy with unspecified pathological lesion in kidney588.8 Other specified disorders resulting from impaired renal function647.60-647.64 Other viral diseases complicating pregnancy (use for HIV I and II)682.0-682.9 Other cellulitis and abscess690.10-690.18 Seborrheic dermatitis696.1 Other psoriasis698.3 Lichenification and lichen simplex chronicus704.8 Other specified diseases of hair and hair follicles706.0-706.9 Diseases of sebaceous glands780.6 Fever780.79 Other malaise and fatigue783.21 Abnormal loss of weight783.40 Lack of expected normal physiological development785.6 Enlargement of lymph nodes786.00 Respiratory abnormality, unspecified786.05 Shortness of breath786.2 Cough786.3 Hemoptysis786.4 Abnormal sputum787.91 Diarrhea795.71 Nonspecific serologic evidence of human immunodeficiency virus799.4 Wasting disease099.8 Other specified venereal disease099.9 Veneral Disease unspecifiedV01.7 Contact with or exposure to communicable diseases, other viral diseasesV71.5 Rape31

Human Immunodeficiency Virus Testing(Prognosis including monitoring)CPT CODES: 8753687539Other Names/Abbreviations: HIV-1 or HIV-2 quantification or viral loadICD-9-CM Codes Covered by Medicare Program:Code:Description:V08Asymptomatic human immunodeficiency virus [HIV] infection status042 Human immunodeficiency virus [HIV] disease079.53 Human immunodeficiency virus, type 2 [HIV-2]647.60-647.64 Other viral diseases complicating pregnancy (including HIV-I and II)795.71 Nonspecific serologic evidence of human immunodeficiency virus [HIV]32

Ionized Calcium (CAION) CPT CODE: 82330ICD-9-CM Codes Covered by Medicare Program:Code: Description:252.0 Hyperparathyroidism252.1 Hypoparathyroidism252.8 Other specified disorders of parathyroid gland252.9 Unspecified disorder of parathyroid gland259.3 Ectopic hormone secretion, not elsewhere classified (ectopic hyperparathyroidism)268.0 Rickets, active268.1 Rickets, late effect268.2 Osteomalacia, unspecified268.9 Unspecified vitamin D deficiency275.40 Unspecified disorders of calcium metabolism275.41 Hypocalcemia275.42 Hypercalcemia275.49 Other disorders of calcium metabolism276.2 Acidosis276.3 Alkalosis276.4 Mixed acid-base balance disorder276.5 Volume depletion276.6 Fluid overload276.9 Electrolyte and fluid disorders not elsewhere classified278.4 Hypervitaminosis D571.5 Cirrhosis of liver without mention of alcohol571.6 Biliary cirrhosis579.0 Celiac disease579.1 Tropical sprue579.2 Blind loop syndrome579.3 Other and unspecified postsurgical nonabsorption579.4 Pancreatic steatorrhea579.8 Other specified intestinal malabsorption579.9 Unspecified intestinal malabsorption585 Chronic renal failure586 Renal failure, unspecified587 Renal sclerosis, unspecified588.0 Renal osteodystrophy588.8 Other specified disorders resulting from impaired renal function588.9 Unspecified disorder resulting from impaired renal function733.00 Osteoporosis, unspecified775.4 Hypocalcemia and hypomagnesemia of newborn775.7 Late metabolic acidosis of newborn775.9 Unspecified endocrine and metabolic disturbances specific to the fetus and newborn780.31 Febrile convulsions780.39 Other convulsions996.81 Complications of transplanted kidney (hyperparathyroidism)996.83 Complications of transplanted heartV42.0 Organ or tissue replaced by transplant, kidney (with secondary hyperparathyroidism)V42.1 Organ or tissue replaced by transplant, heartV42.84 Organ or tissue replaced by transplant; intestinesV56.0 Extracorporeal dialysis (with secondary hyperparathyroidism)33

Iron Studies, Serum (Ferritin,Iron, Iron Binding Capacity,Transferrin)CPT CODES: 82728 83540 8355084466ICD-9-CM Codes Covered by Medicare Program:Code:Description:002.0-002.9 Typhoid and paratyphoid fevers003.0-003.9 Other salmonella infections006.0-006.9 Amebiasis007.0-007.9 Other protozoal intestinal diseases008.00-008.8 Intestinal infections due to other organisms009.0-009.3 Ill-defined intestinal infections011.50-011.56 Tuberculous bronchiectasis014.00-014.86 Tuberculosis of intestines, peritoneum, and mesenteric glands015.00-015.96 Tuberculosis of bones and joints016.00-016.06 Tuberculosis of kidney016.10-016.16 Tuberculosis of bladder016.20-016.26 Tuberculosis of ureter016.30-016.36 Tuberculosis of other urinary organs042 Human Immunodeficiency virus (HIV) disease070.0-070.9 Viral hepatitis140.0-149.9 Malignant neoplasm of lip oral cavity and pharynx150.0-159.9 Malignant neoplasm of digestive organs and peritoneum160.0-165.9 Malignant neoplasm of respiratory and intrathoracic organs170.0-176.9 Malignant neoplasm of bone, connective tissue, skin and breast179-189.9 Malignant neoplasm of genitourinary organs190.0-199.1 Malignant neoplasm of other and unspecified sites200.00-208.91 Malignant neoplasm of lymphatic and hematopoietic tissue210.0-229.9 Benign neoplasms230.0-234.9 Carcinoma in situ235.0-238.9 Neoplasms of uncertain behavior239.0-239.9 Neoplasms of unspecified nature250.00-250.93 Diabetes mellitus253.2 Panhypopituitarism253.7 Iatrogenic pituitary disorders253.8 Other disorders of the pituitary and other syndromes of diencephalohypophysial origin256.31-256.39 Other ovarian failure257.2 Other testicular hypofunction260 Kwashiorkor261 Nutritional marasmus262 Other severe protein-calorie malnutrition263.0-263.9 Other and unspecified protein-calorie malnutrition275.0 Disorders of iron metabolism277.1 Disorders of porphyrin metabolism280.0-280.9 Iron deficiency anemias281.0-281.9 Other deficiency anemias282.4 Thalassemias282.60-282.63 Sickle-cell anemia282.69 Other sickle-cell anemia285.0 Sideroblastic anemia (includes hemochromatosis with refractory anemia)34

Code:Description:285.1 Acute post-hemorrhagic anemia285.21 Anemia in end-stage renal disease285.9 Anemia, unspecified286.0-286.9 Coagulation defects (congenital factor disorders)287.0-287.9 Purpura and other hemorrhagic conditions306.4 Physiological malfunction arising from mental factors, gastrointestinal307.1 Anorexia nervosa307.50-307.59 Other and unspecified disorders of eating425.4 Other primary cardiomyopathies425.5 Alcoholic cardiomyopathy425.7 Nutritional and metabolic cardiomyopathy425.8 Cardiomyopathy in other diseases classified elsewhere425.9 Secondary cardiomyopathy, unspecified426.0-426.9 Conduction disorders427.0-427.9 Cardiac dysrhythmias428.0-428.9 Heart Failure530.7 Gastroesophageal laceration-hemorrhage syndrome530.82 Esophageal hemorrhage531.00-531.91 Gastric ulcer532.00-532.91 Duodenal ulcer533.00-533.91 Peptic ulcer, site unspecified534.00-534.91 Gastrojejunal ulcer535.00-535.61 Gastritis and duodenitis536.0-536.9 Disorders of function of stomach537.83 Angiodysplasia of stomach and duodenum with hemorrhage537.84 Dieulafoy lesion (hemorrhagic) of stomach and duodenum555.0-555.9 Regional enteritis556.0-556.9 Ulcerative colitis557.0 Acute vascular insufficiency of intestine557.1 Chronic vascular insufficiency of intestine562.02 Diverticulosis of small intestine with hemorrhage562.03 Diverticulitis of small intestine with hemorrhage562.12 Diverticulosis of colon with hemorrhage562.13 Diverticulitis of colon with hemorrhage569.3 Hemorrhage of rectum and anus569.85 Angiodysplasia of intestine with hemorrhage569.86 Dieulafoy lesion (hemorrhagic) of intestine570 Acute and subacute necrosis of liver571.0-571.9 Chronic liver disease and cirrhosis572.0-572.8 Liver abscess and sequelae of chronic liver disease573.0-573.9 Other disorders of liver578.0-578.9 Gastrointestinal hemorrhage579.0-579.3 Intestinal malabsorption579.8-579.9 Other specified and unspecified intestinal malabsorption581.0-581.9 Nephrotic syndrome585 Chronic renal failure586 Renal failure, unspecified608.3 Atrophy of testis626.0-626.9 Disorders of menstruation and other abnormal bleeding from female genital tract627.0 Premenopausal menorrhagia627.1 Postmenopausal bleeding648.20-648.24 Other current conditions in the mother classifiable elsewhere, but complicating pregnancy,childbirth, or the puerperium: Anemia35

Code:Description:698.0-698.9 Pruritus and related conditions704.00-704.09 Alopecia709.00-709.09 Dyschromia713.0 Arthropathy associated with other endocrine and metabolic disorders716.40-716.99 Other and unspecified arthropathies719.40-719.49 Pain in joint773.2 Hemolytic disease due to other and unspecified isoimmunization773.3 Hydrops fetalis due to isoimmunization773.4 Kernicterus due to isoimmunization773.5 Late anemia due to isoimmunization783.9 Other symptoms concerning nutrition, metabolism and development790.01-790.09 Abnormality of red blood cells790.4 Nonspecific elevation of levels of transaminase or lactic acid dehydrogenase [LDH]790.5 Other nonspecific abnormal serum enzyme levels790.6 Other abnormal blood chemistry799.4 Cachexia964.0 Poisoning by agents primarily affecting blood constituents, iron compounds984.0-984.9 Toxic effect of lead and its compounds (including fumes)996.85 Complications of transplanted organ, bone marrow999.8 Other transfusion reactionV08Asymptomatic HIV infectionV12.1 Personal history of nutritional deficiencyV12.3 Personal history of diseases of blood and blood forming organsV15.1 Personal history of surgery to heart and great vesselsV15.2 Personal history of surgery to other major organsV43.2 Heart replaced by other meansV43.3 Heart valve replaced by other meansV43.4 Blood vessel replaced by other meansV43.60 Unspecified joint replaced by other meansV56.0 Extracorporeal dialysisV56.8 Other dialysisV72.84 Pre-operative examination, unspecified36

Lipids (Lipid Panel, Cholesterol,Lipoprotein Electrophoresis or HighResolution Fractionation, HDLCholesterol, LDL Cholesterol – DirectMeasurement, Triglycerides)CPT CODES: 8006182465 83715 8371683718 83721 84478ICD-9-CM Codes Covered by Medicare Program:Code:Description:242.00-245.9 Disorders of the thyroid gland with hormonal dysfunction250.00-250.93 Diabetes mellitus255.0 Cushing's syndrome260 Kwashiorkor261 Nutritional marasmas262 Other severe, protein-calorie malnutrition263.0 Malnutrition of moderate degree263.1 Malnutrition of mild degree263.8 Other protein-calorie malnutrition263.9 Unspecified protein-calorie malnutrition270.0 Disturbances of amino-acid transport271.1 Galactosemia272.0 Pure hypercholesterolemia272.1 Hyperglyceridemia272.2 Mixed hyperlipidemia (tuberous xanthoma)272.3 Hyperchylomicronemia272.4 Other and unspecified hyperlipidemia (unspecified xanthoma)272.5 Lipoprotein deficiencies272.6 Lipodystrophy272.7 Lipidoses272.8 Other disorders of lipoid metabolism272.9 Unspecified disorders of lipoid metabolism277.3 Amyloidosis278.00 Obesity278.01 Morbid obesity303.90-303.92 Alcoholism362.10-362.16 Other background retinopathy and retinal vascular change362.30-362.34 Retinal vascular occlusion362.82 Retinal exudates and deposits371.41 Senile corneal changes374.51 Xanthelasma379.22 Crystalline deposits in vitreous388.00 Degenerative & vascular disorder of ear, unspecified388.02 Transient ischemic deafness401.0, 401.9 Essential hypertension402.00-402.91 Hypertensive heart disease403.00-403.91 Hypertensive renal disease404.00-404.93 Hypertensive heart and renal disease405.01-405.99 Secondary hypertension410.00-410.92 Acute myocardial infarction411.0-411.1 Other acute & subacute forms of ischemic heart disease411.81 Coronary occlusion without myocardial infarction37

Code:Description:411.89 Other acute and subacute ischemic heart disease412 Old myocardial infarction413.0-413.1 Angina pectoris413.9 Other and unspecified angina pectoris414.00-414.03 Coronary atherosclerosis414.04 Coronary atherosclerosis of artery bypass graft414.05 Coronary athrscl-unspec graft414.06 Coronary atherosclerosis of coronary artery of transplanted heart414.10 Aneurysm of heart (wall)414.11 Coronary vessel aneurysm414.12 Dissection of coronary artery414.19 Other aneurysm of heart414.8 Other specified forms of chronic ischemic heart disease414.9 Chronic ischemic heart disease, unspecified428.0-428.9 Heart failure429.2 Heart disease, unspecified429.9 Heart disease NOS431 Intracerebral hemorrhage433.00-433.91 Occlusion & stenosis of precerebral arteries434.00-434.91 Occlusion of cerebral arteries435.0-435.9 Transient cerebral ischemia437.0 Cerebral atherosclerosis437.1 Other generalized ischemic cerebrovascular disease437.5 Moyamoya disease438.0-438.9 Late effects of cerebrovascular disease440.0-440.9 Arteriosclerosis441.00-441.9 Aortic aneurysms442.0 Upper extremity aneurysm442.1 Renal artery aneurysm442.2 Iliac artery aneurysm444.0-444.9 Arterial embolism & thrombosis557.1 Chronic vascular insufficiency of intestine571.8 Other chronic non-alcoholic liver disease571.9 Unspecified chronic liver disease without mention of alcohol573.8 Other specified disorders of liver573.9 Unspecified disorders of liver577.0-577.9 Pancreatic disease579.3 Other & unspecified postsurgical nonabsorption579.8 Other specified intestinal malabsorption581.0-581.9 Nephrotic syndrome584.5 Acute renal failure with lesion of tubular necrosis585 Chronic renal failure588.0 Renal osteodystrophy588.1 Nephrogenic diabetes insipidus588.8 Other specified disorders resulting from impaired renal function588.9 Unspecified disorder resulting from impaired renal function607.84 Impotence of organic origin, penis disorder646.70-646.71 Liver disorders in pregnancy646.73 Liver disorder antepartum648.10-648.14 Thyroid disfunction in pregnancy and the puerperium696.0 Psoriatic arthropathy696.1 Other psoriasis751.61 Biliary atresia38

Code:Description:764.10-764.19 "Light for dates" with signs of fetal malnutrition786.50 Chest pain unspecified786.51 Precordial pain786.59 Chest pain, other789.1 Hepatomegaly790.4 Abnormal transaminase790.5 Abnormal alkaline phosphatase790.6 Other abnormal blood chemistry793.4 Abnormal imaging study987.9 Toxic effect of unspecified gas or vapor996.81 Complication of transplanted organ, kidneyV42.0 Transplanted organ, kidneyV42.7 Organ Replacement by transplant,liverV58.69 Long term (current) use of other medications39

Partial Thromboplastin Time (PTT) CPT CODE: 85730ICD-9-CM Codes Covered by Medicare Program:Code:Description:002.0–002.9 Typhoid and paratyphoid003.0–003.9 Other Salmonella infections038.9 Unspecified Septicemia042 Human immunodeficiency virus (HIV) disease060.0-060.9 Yellow fever065.0-065.9 Arthropod borne hemorrhagic fever070.0-070.9 Viral Hepatitis075 Infectious mononucleosis078.6 Hemorrhagic nephrosonephritis078.7 Arenaviral hemorrhagic fever120.0 Schistosomiasis haematobium121.1 Clonorchiasis121.3 Fascioliasis124 Trichinosis135 Sarcoidosis155.0-155.2 Malignant neoplasm of liver and intrahepatic bile ducts197.7 Malignant neoplasm of liver, specified as secondary238.4 Polycythemia vera238.7 Other lymphatic and hemapoietic tissues239.9 Neoplasm of unspecified nature, site unspecified246.3 Hemorrhage and infarction of thyroid250.40-250.43 Diabetic with renal manifestations269.0 Deficiency of Vitamin K273.0-273.9 Disorders of plasma protein metabolism275.0-275.9 Disorders of iron metabolism277.1 Disorders of porphyrin metabolism277.3 Amyloidosis285.1 Acute posthemorrhagic anemia286.0 Congenital factor VIII disorder - Hemophilia A286.1 Congenital factor IX disorder - Hemophilia B286.2-286.3 Other congenital factor deficiencies286.4 von Willebrand's disease286.5 Hemorrhagic disorder due to circulating anticoagulants286.6 Defibrination syndrome286.7 Acquired coagulation factor deficiency286.9 Other and unspecified coagulation defects287.0-287.9 Purpura and other hemorrhagic conditions289.0 Polycythemia, secondary325 Phlebitis and thrombophlebitis of intracranial venous sinuses360.43 Hemophthalmos, except current injury362.30-362.37 Retinal vascular occlusion362.43 Hemorrhagic detachment of retinal pigment epithelium362.81 Retinal hemorrhage363.61-363.63 Choroidal hemorrhage363.72 Choroidal detachment368.9 Unspecified Visual Disturbances372.72 Conjunctive hemorrhage40

Code:Description:374.81 Hemorrhage of eyelid376.32 Orbital hemorrhage377.42 Hemorrhage in optic nerve sheaths379.23 Vitreous hemorrhage380.31 Hematoma of auricle or pinna403.01, 403.11, 403.91 Hypertensive Renal Disease with renal failure404.02, 404.12, 404.92 Hypertensive Heart and Renal Disease with renal failure410.00-410.92 Acute myocardial infarction423.0 Hemopericardium427.31 Atrial fibrillation427.9 Cardiac dysrhythmias, unspecified428.0 Congestive heart failure, unspecified429.79 Mural thrombus430-432.9 Cerebral hemorrhage433.00-433.91 Occlusion and stenosis of precerebral arteries434.00-434.91 Occlusion of cerebral arteries435.9 Focal neurologic deficit444.0-444.9 Arterial embolism and thrombosis446.6 Thrombotic microangiopathy447.2 Rupture of artery448.0 Hereditary Hemorrhagic telangiectasia451.0-451.9 Phlebitis and thrombophlebitis453.0-453.9 Other Venous emboli and thrombosis456.0 Esophageal varices with bleeding456.1 Esophageal varices without bleeding456.8 Varices of other sites459.89 Ecchymosis530.7 Gastroesophageal laceration – hemorrhage syndrome530.82 Esophageal hemorrhage531.00-535.61 Gastric-Duodenal ulcer disease537.83 Angiodysplasia of stomach and duodenum with hemorrhage537.84 Dieulafoy lesion (hemorrhagic) of stomach and duodenum556.0-557.9 Hemorrhagic bowel disease562.02-562.03 Diverticulosis of small intestine with hemorrhage562.12 Diverticulosis of colon with hemorrhage562.13 Diverticulitis of colon with hemorrhage568.81 Hemoperitoneum (nontraumatic)569.3 Hemorrhage of rectum and anus570 Acute and subacute necrosis of liver571.0-573.9 Liver disease (in place of specific codes listed)576.0-576.9 Biliary tract disorders577.0 Acute pancreatitis578.0-578.9 Gastrointestinal Hemorrhage579.0-579.9 Malabsorption581.0-581.9 Nephrotic Syndrome583.9 Nephritis, with unspecified pathological lesion in kidney584.5-584.9 Acute Renal Failure585 Chronic Renal Failure586 Renal failure593.81-593.89 Other disorders of kidney and ureter, with hemorrhage596.7 Hemorrhage into bladder wall596.8 Other disorders of bladder, with hemorrhage599.7 Hematuria41

Code:Description:607.82 Penile hemorrhage608.83 Vascular disorders of male genital organs611.8 Hematoma of breast620.7 Hemorrhage of broad ligament621.4 Hematometra622.8 Other specified disorders of cervix, with hemorrhage623.6 Vaginal hematoma623.8 Other specified diseases of the vagina, with hemorrhage624.5 Hematoma of vulva626.6 Metrorrhagia626.7 Postcoital bleeding627.0 Premenopausal bleeding627.1 Postmenopausal bleeding629.0 Hematocele female not elsewhere classified632 Missed abortion634.00-634.92 Spontaneous abortion635.10-635.12 Legally induced abortion, complicated by delayed or excessive hemorrhage636.10-636.12 Illegally induced abortion, complicated by delayed or excessive hemorrhage637.10-637.12 Abortion unspecified, complicated by delayed or excessive hemorrhage638.1 Failed attempt abortion, complicated by delayed or excessive hemorrhage639.1 Delayed or excessive hemorrhage following abortion and ectopic and molar pregnancies639.6 Complications following abortion and ectopic and molar pregnancies, embolism640.00-640.93 Hemorrhage in early pregnancy641.00-641.93 Antepartum hemorrhage642.00-642.94 Hypertension complicating pregnancy, childbirth, and the puerperium646.70-646.73 Liver disorders in pregnancy656.00-656.03 Fetal maternal hemorrhage658.40-658.43 Infection of amniotic cavity666.00-666.34 Postpartum hemorrhage671.20-671.54 Phlebitis in pregnancy673.00-673.84 Obstetrical pulmonary embolus674.30-674.34 Other complications of surgical wounds, with hemorrhage710.0 Systemic Lupus erythematosus713.2 Arthropathy associated with hematologic disorders (note: may not be used without indicatingassociated condition first)713.6 Arthropathy associated with Henoch Schonlein (note: may not be used without indicatingassociated condition first)719.10-719.19 Hemarthrosis729.5 Leg pain/calf pain733.10-733.19 Pathologic fracture associated with fat embolism762.1 Other forms of placental separation with hemorrhage (affecting newborn code – do not assign tomother’s record)764.90-764.99 Fetal intrauterine growth retardation767.0-767.1 Subdural and cerebral hemorrhage767.8 Other specified birth trauma, with hemorrhage770.3 Fetal and newborn pulmonary hemorrhage772.0-772.9 Fetal and neonatal hemorrhage774.0-774.7 Other perinatal jaundice776.0-776.9 Hemorrhagic disease of the newborn780.2 Syncope782.4 Jaundice, unspecified, not of newborn782.7 Spontaneous ecchymoses Petechiae784.7 Epistaxis42

Code:Description:784.8 Hemorrhage from throat785.4 Gangrene785.50 Shock786.05 Shortness of breath786.3 Hemoptysis786.50 Chest pain, unspecified786.59 Chest pain789.00-789.09 Abdominal pain790.92 Abnormal coagulation profile800.00-800.99 Fracture of vault of skull801.00-801.99 Fracture of base of skull802.20-802.9 Fracture of face bones803.00-803.99 Other fracture, skull804.00-804.99 Multiple fractures, skull805.00- 806.9 Fracture, vertebral column807.00-807.09 Fractures of rib(s), closed807.10-807.19 Fracture of rib(s), open808.8-808.9 Fracture of pelvis809.0-809.1 Fracture of trunk810.00-810.13 Fracture of clavicle811.00-811.19 Fracture of scapula812.00-812.59 Fracture of humerus813.10-813.18 Fracture of radius and ulna, upper end, open813.30-813.33 Fracture of radius and ulna, shaft, open813.50-813.54 racture of radius and ulna, lower end, open813.90-813.93 Fracture of radius and ulna, unspecified part, open819.0-819.1 Multiple fractures820.00–821.39 Femur823.00-823.92 Tibia and fibula827.0–829.1 Other multiple lower limb852.00–853.19 Subarachnoid subdural, and extradural hemorrhage, following injury, Other and specifiedintracranial hemorrhage following injury860.0-860.5 Traumatic pneumothorax and hemothorax861.00-861.32 Injury to heart and lung862.0-862.9 Injury to other and unspecified intrathoracic organs863.0-863.99 Injury to gastrointestinal tract864.00-864.19 Injury to liver865.00-865.19 Injury to spleen866.00-866.13 Injury to kidney867.0-867.9 Injury to pelvic organs868.00-868.19 Injury to other intra-abdominal organs869.0-869.1 Internal injury to unspecified or ill defined organs900.00-900.9 Injury to blood vessels of head and neck901.0-901.9 Injury to blood vessels of the thorax902.0-902.9 Injury to blood vessels of the abdomen and pelvis903.00-903.9 Injury to blood vessels of upper extremity904.0-904.9 Injury to blood vessels of lower extremity and unspecified sites920 - 924.9 Contusion with intact skin surface925.1-929.9 Crushing injury958.2 Secondary and recurrent hemorrhage959.9 Injury, unspecified site964.2 Poisoning by anticoagulants964.5 Poisoning by anticoagulant antagonists43

Code:Description:964.7 Poisoning by natural blood and blood products980.0 Toxic effects of alcohol989.5 Snake venom995.2 Unspecified adverse effect of drug, medicinal and biological substance (due to correct medicinalsubstance properly administered)996.70-996.79 Other complications of internal prosthetic device997.02 Iatrogenic cerebrovascular infarction or hemorrhage998.11 Hemorrhage or hematoma complicating a procedure999.2 Other vascular complications of medical careV12.3 Personal history of diseases of blood and blood forming organsV58.2 Admission for Transfusion of blood productsV58.61 Long term (current use) of anticoagulantsV72.81 Pre-operative cardiovascular examinationV72.83 Other specified pre-operative examinationV72.84 Pre-operative examination, unspecified44

Percent free Prostate Specific Antigen(Free PSA)CPT CODE: 84154ICD-9-CM Codes Covered by Medicare Program:Code:Description:185 Malignant neoplasm of prostate222.2 Benign neoplasm of male genital organs - prostate236.5 Neoplasm of uncertain behavior of genitourinary organs - prostate790.93 Elevated prostate-specific antigen45

Prostate Specific Antigen (PSA) CPT CODE: 84153ICD-9-CM Codes Covered by Medicare Program:Code:Description:185 Malignant neoplasm of prostate188.5 Malignant neoplasm of bladder neck196.5 Secondary malignant neoplasm, lymph nodes inguinal region and lower limb196.6 Secondary malignant neoplasm, intrapelvic lymph nodes196.8 Secondary malignant neoplasm, lymph nodes of multiple sites198.5 Secondary malignant neoplasm, bone and bone marrow198.82 Secondary malignant neoplasm, genital organs233.4 Carcinoma in situ, prostate236.5 Neoplasm of uncertain behavior of prostate239.5 Neoplasm of unspecified nature, other genitourinary organs596.0 Bladder neck obstruction599.6 Urinary obstruction, unspecified599.7 Hematuria601.9 Unspecified prostatitis602.9 Unspecified disorder of prostate788.20 Retention of urine, unspecified788.21 Incomplete bladder emptying788.30 Urinary incontinence, unspecified788.41 Urinary frequency788.43 Nocturia788.62 Slowing of urinary stream790.93 Elevated prostate specific antigen793.6-793.7 Non-specific abnormal result of radiologic examination, evidence of malignancy794.9 Bone scan evidence of malignancyV10.46 Personal history of malignant neoplasm; prostate46

Prothrombin Time (PT) CPT CODE: 85610ICD-9-CM Codes Covered by Medicare Program:Code:Description:002.0-002.9 Typhoid and paratyphoid003.0-003.9 Other Salmonella infections038.9 Unspecified Septicemia042 Human Immunodeficiency virus (HIV) disease060.0-060.9 Yellow fever065.0-065.9 Arthropod-borne hemorrhagic fever070.0-070.9 Viral hepatitis075 Infectious mononucleosis078.6 Hemorrhagic nephrosonephritis078.7 Arenaviral hemorrhagic fever084.8 Blackwater fever120.0 Schistosomiasis121.1 Clonorchiasis121.3 Fascioliasis124 Trichinosis134.2 Hirudiniasis135 Sarcoidosis152.0-152.9 Malignant neoplasm of small intestine, including duodenum155.0-155.2 Malignant neoplasm of liver and intrahepatic bile ducts156.0-156.9 Malignant neoplasm of gallbladder and extrahepatic bile ducts157.0-157.9 Malignant neoplasm of pancreas188.0-189.9 Malignant neoplasm of bladder, kidney, and other and unspecified urinary organs198.0 Secondary malignant neoplasm, kidney198.1 Secondary malignant neoplasm, other urinary organs200.00-200.88 Lymphosarcoma and reticulosarcoma202.00-202.98 Other malignant neoplasms of lymphoid and histiocytic tissue223.0-223.9 Benign neoplasm of kidney and other urinary organs238.4 Polycythemia vera238.5 Histocytic and mast cells – neoplasm of uncertain behavior238.6 Plasma cells – neoplasm of uncertain behavior238.7 Other lymphatic and hematopoietic tissues239.4 Neoplasm of unspecified nature, bladder239.5 Neoplasm of unspecified nature, other genitourinary organs239.9 Neoplasm of unspecified nature, site unspecified246.3 Hemorrhage and infarction of thyroid250.40-250.43 Diabetic with renal manifestations263.0-263.9 Other and unspecified protein/calorie malnutrition269.0 Deficiency of Vitamin K269.2 Unspecified vitamin deficiency273.0-273.9 Disorders of plasma protein metabolism275.0 Disorders of iron metabolism277.1 Disorders of porphyrin metabolism277.3 Amyloidosis280.0 Iron deficiency anemia, secondary to blood loss - chronic280.9 Iron deficiency anemia, unspecified281.0 Pernicious anemia281.1 Other Vitamin B12 Deficiency Anemia, NEC47

Code:Description:281.9 Unspecified Deficiency Anemia, NOS285.0 Sideroblastic anemia285.1 Acute posthemorrhagic anemia286.0-286.9 Coagulation defects287.0-287.9 Purpura and other hemorrhagic conditions290.40-290.43 Arteriosclerotic dementia325 Phlebitis and thrombophlebitis of intracranial venous sinuses342.90-342.92 Hemiplegia NOS360.43 Hemophthalmos, except current injury362.18 Retinal vasculitis362.30-362.37 Retinal vascular occlusion362.43 Hemorrhagic detachment of retinal pigment epithelium362.81 Retinal hemorrhage363.61-363.72 Choroidal hemorrhage and rupture, detachment368.9 Unspecified Visual Disturbances372.72 Conjunctival hemorrhage374.81 Hemorrhage of eyelid376.32 Orbital hemorrhage377.42 Hemorrhage in optic nerve sheaths377.53 Disorders of optic chiasm associated with vascular disorders377.62 Disorders of visual pathways associated with vascular disorders377.72 Disorders of visual cortex associated with vascular disorders379.23 Vitreous hemorrhage380.31 Hematoma of auricle or pinna386.2 Vertigo of central origin386.50 Labyrinthine dysfunction, unspecified394.0-394.9 Diseases of the mitral valve395.0 Rheumatic aortic stenosis395.2 Rheumatic aortic stenosis with insufficiency396.0-396.9 Diseases of mitral and aortic valves397.0-397.9 Diseases of other endocardial structures398.0-398.99 Other rheumatic heart disease403.01, 403.11, Hypertensive Renal Disease with renal failure403.91404.02, 404.12, Hypertensive Heart and Renal Disease with renal failure404.92410.00-410.92 Acute myocardial infarction411.1 Intermediate coronary syndrome411.81 Coronary occlusion without myocardial infarction411.89 Other acute and subacute forms of ischemic heart disease413.0-413.9 Angina pectoris414.00-414.06 Coronary atherosclerosis414.8 Other specified forms of chronic ischemic heart disease414.9 Chronic ischemic heart disease, unspecified415.0-415.19 Acute pulmonary heart disease416.9 Chronic pulmonary heart disease, unspecified423.0 Hemopericardium424.0 Mitral valve disorders424.1 Aortic valve disorder424.90 Endocarditis, valve unspecified, unspecified cause425.0-425.9 Cardiomyopathy427.0-427.9 Cardiac dysrhythmias428.0-428.9 Heart failure48

Code:Description:429.0-429.4 Ill-defined descriptions and complications of heart disease429.79 Other certain sequelae of myocardial infarction, not elsewhere classified430 Subarachnoid hemorrhage431 Intracerebral hemorrhage432.0-432.9 Other and unspecified intracranial hemorrhage433.00-433.91 Occlusion and stenosis of precerebral arteries434.00-434.91 Occlusion of cerebral arteries435.0-435.9 Transient cerebral ischemia436 Acute, but ill-defined cerebrovascular disease437.0 Cerebral atherosclerosis437.1 Other generalized ischemic cerebrovascular disease437.6 Nonpyogenic thrombosis of intracranial venous sinus440.0-440.9 Atherosclerosis441.0-441.9 Aortic aneurysm and dissection443.0-443.9 Other peripheral vascular disease444.0-444.9 Arterial embolism and thrombosis447.1 Stricture of artery447.2 Rupture of artery447.6 Arteritis, unspecified448.0 Hereditary hemorrhagic telangiectasia448.9 Other and unspecified capillary diseases451.0-451.9 Phlebitis and thrombophlebitis452 Portal vein thrombosis453.0-453.9 Other venous embolism and thrombosis455.2 Internal hemorrhoids with other complication455.5 External hemorrhoids with other complication455.8 Unspecified hemorrhoids with other complication456.0-456.1 Esophageal varices456.8 Varices of other sites459.0 Hemorrhage, unspecified459.10-459.19 Postphlebetic syndrome459.2 Compression of vein459.81 Venous (peripheral) insufficiency, unspecified459.89 Other, other specified disorders of circulatory system511.8 Other specified forms of effusion, except tuberculosis514 Pulmonary congestion and hypostasis530.7 Gastroesophageal laceration – hemorrhage syndrome530.82 Esophageal hemorrhage531.00-535.61 Gastric ulcer, duodenal ulcer, peptic ulcer, gastrojejunal ulcer, gastritis and duodenitis555.0-555.9 Regional enteritis556.0-556.9 Ulcerative colitis557.0-557.9 Vascular insufficiency of intestine562.02 - 562.03 Diverticulosis of small intestine with hemorrhage562.10 Diverticulosis of colon w/o hemorrhage562.11 Diverticulitis of colon w/o hemorrhage562.12 Diverticulosis of colon with hemorrhage562.13 Diverticulitis of colon with hemorrhage568.81 Hemoperitoneum (nontraumatic)569.3 Hemorrhage of rectum and anus571.0-571.9 Chronic liver disease and cirrhosis572.2 Hepatic coma572.4 Hepatorenal syndrome572.8 Other sequelae of chronic liver disease49

Code:Description:573.1-573.9 Hepatitis in viral diseases, other and unspecified disorder of liver576.0-576.9 Other disorders of Biliary tract577.0 Acute pancreatitis578.0-578.9 Gastrointestinal hemorrhage579.0-579.9 Intestinal Malabsorption581.0-581.9 Nephrotic Syndrome583.9 Nephritis, with unspecified pathological lesion in kidney584.5-584.9 Acute Renal Failure585 Chronic Renal Failure586 Renal failure, unspecified593.81-593.89 Other specified disorders of kidney and ureter596.7 Hemorrhage into bladder wall596.8 Other specified disorders of bladder599.7 Hematuria607.82 Vascular disorders of penis608.83 Vascular disorders of male genital organs611.8 Other specified disorders of breast - hematoma620.7 Hematoma of broad ligament621.4 Hematometra622.8 Other specified noninflammatory disorders of cervix623.6 Vaginal hematoma623.8 Other specified noninflammatory disorders of the vagina624.5 Hematoma of vulva626.2-626.9 Abnormal bleeding from female genital tract627.0 Premenopausal menorrhagia627.1 Postmenopausal bleeding629.0 Hematocele female, not classified elsewhere632 Missed abortion634.10-634.12 Spontaneous abortion, complicated by excessive hemorrhage635.10-635.12 Legally induced abortion, complicated by delayed or excessive hemorrhage636.10-636.12 Illegally induced abortion, complicated by delayed or excessive hemorrhage637.10-637.12 Abortion unspecified, complicated by delayed or excessive hemorrhage638.1 Failed attempted abortion, complicated by delayed or excessive hemorrhage639.1 Delayed or excessive hemorrhage following abortion and ectopic and molar pregnancies639.6 Complications following abortion and ectopic and molar pregnancies with embolism640.00-640.93 Hemorrhage in early pregnancy641.00-641.93 Antepartum hemorrhage, abruptio placentae, and placenta previa642.00-642.94 Hypertension complicating pregnancy, childbirth, and the puerperium646.70-646.73 Liver disorders in pregnancy656.00-656.03 Fetal maternal hemorrhage658.40-658.43 Infection of amniotic cavity666.00-666.34 Postpartum hemorrhage671.20-671.94 Venous complications in pregnancy and the puerperium except legs, vulva and perineum673.00-673.84 Obstetrical pulmonary embolism674.30-674.34 Other complications of obstetrical surgical wounds713.2 Arthropathy associated with hematological disorders713.6 Arthropathy associated with hypersensitivity reaction719.15 Hemarthrosis pelvic region and thigh719.16 Lower leg719.19 Multiple sites729.5 Pain in limb733.10 Pathologic fracture, unspecified site746.00-746.9 Other Congenital anomalies of heart50

Code:Description:762.1 Other forms of placental separation and hemorrhage767.0-767.1 Birth trauma, subdural and cerebral hemorrhage and injury to scalp767.8 Other specified birth trauma770.3 Pulmonary hemorrhage772.0-772.9 Fetal and neonatal hemorrhage774.6 Unspecified fetal and neonatal jaundice776.0-776.9 Hemorrhagic disease of the newborn780.2 Syncope and collapse782.3 Edema782.4 Jaundice, unspecified, not of newborn782.7 Spontaneous ecchymosis784.7 Epistaxis784.8 Hemorrhage from throat785.4 Gangrene785.50 Shock without mention of trauma786.05 Shortness of breath786.3 Hemoptysis786.59 Chest pain, other789.00-789.09 Abdominal pain789.1 Hepatomegaly789.5 Ascites790.92 Abnormal coagulation profile790.94 Euthyroid sick syndrome791.2 Hemoglobinuria794.8 Abnormal Liver Function Study800.00-800.99 Fracture of vault of skull801.00-801.99 Fracture of base of skull802.20-802.9 Fracture of face bones803.00-803.99 Other and unqualified skull fractures804.00-804.99 Multiple fractures involving skull or face with other bones805.00-806.9 Fracture, vertebral column807.00-807.09 Fractures of rib(s), closed807.10-807.19 Fracture of rib(s), open808.8-808.9 Unspecified fracture of pelvis809.0-809.1 Ill-defined fractures of bones of trunk810.00-810.13 Fracture of clavicle811.00-811.19 Fracture of scapula812.00-812.59 Fracture of humerus813.10-813.18 Fracture of radius and ulna, upper end, open813.30-813.33 Shaft, open813.50-813.54 Lower end, open813.90-813.93 Fracture unspecified part, open819.0-819.1 Multiple fractures involving both upper limbs, closed and open820.00-821.39 Fracture of neck of femur823.00-823.92 Fracture of tibia and fibula827.0-829.1 Other multiple lower limb852.00-853.19 Subarachnoid subdural, and extradural hemorrhage, following injury, Other and specifiedintracranial hemorrhage following injury860.0-860.5 Traumatic pneumothorax and hemothorax861.00-861.32 Injury to heart and lung862.0-862.9 Injury to other and unspecified intrathoracic organs863.0-863.90 Injury to gastrointestinal tract864.00-864.19 Injury to liver51

Code:Description:865.00-865.19 Injury to spleen866.00-866.13 Injury to kidney867.0-867.9 Injury to pelvic organs868.00-868.19 Injury to other intra-abdominal organs869.0-869.1 Internal injury to unspecified or ill defined organs900.00-900.9 Injury to blood vessels of head and neck901.0-901.9 Injury to blood vessels of the thorax902.0-902.9 Injury to blood vessels of the abdomen and pelvis903.00-903.9 Injury to blood vessels of upper extremity904.0-904.9 Injury to blood vessels of lower extremity and unspecified sites920-924.9 Contusion with intact skin surface925.1-929.9 Crushing injury958.2 Secondary and recurrent hemorrhage959.9 Injury, unspecified site964.0-964.9 Poisoning by agents primarily affecting blood constituents980.0-980.9 Toxic effect of alcohol981 Toxic effect of petroleum products982.0-982.8 Toxic effects of solvents other than petroleum-based987.0-987.9 Toxic effect of other gases, fumes or vapors989.0-989.9 Toxic effect of other substances chiefly non-medicinal as to source995.2 Unspecified adverse effect of drug, medicinal and biological substance (due to correct medicinalsubstance properly administered)996.82 Complication of transplanted liver997.02 Iatrogenic cerebrovascular infarction or hemorrhage997.4 Digestive system complications998.11-998.12 Hemorrhage or hematoma complicating a procedure999.2 Other vascular complications999.8 Other transfusion reactionsV08Asymptomatic HIV infectionV12.1 History of nutritional deficiencyV12.3 Personal history of diseases of blood and blood-forming organsV12.50-V12.59 Diseases of circulatory systemV15.1 Personal history of surgery to heart and great vesselsV15.2 Personal history of surgery of other major organsV42.0 Kidney replaced by transplantV42.1 Heart replaced by transplantV42.2 Heart valve replaced by transplantV42.6 Lung replaced by transplantV42.7 Liver replaced by transplantV42.81-V42.89 Other specified organ or tissue replaced by transplantV43.2 Heart replaced by other meansV43.3 Heart valve replaced by other meansV43.4 Blood vessel replaced by other meansV43.60 Unspecified joint replaced by other meansV58.2 Transfusion of blood productsV58.61 Long-term (current) use of anticoagulantsV72.84 Pre-operative examination, unspecified52

Syphilis Test; Qualitative (e.g. VDRL, RPR) CPT CODE: 86592ICD-9-CM Codes Covered by Medicare Program:Code:Description:042 Human immunodeficiency virus [HIV} disease054.10 Genital herpes, unspecified054.11 Genital herpes; herpetic vulvovaginitis054.12 Genital herpes; herpetic ulceration of vulva054.13 Genital herpes; herpetic infection of penis054.19 Genital herpes; other078.0 Other diseases due to viruses and Chlamydia; molluscum contagiosum078.10 Other diseases due to viruses and Chlamydia; viral warts, unspecified078.11 Other diseases due to viruses and Chlamydia; condyloma acuminatum078.19 Other diseases due to viruses and Chlamydia; other specified viral warts090.0 Early congenital syphilis, symptomatic090.1 Early congenital syphilis, latent090.2 Early congenital syphilis, unspecified090.3 Syphilitic interstitial keratitis090.40 Juvenile neurosyphilis, unspecified090.41 Congenital syphilitic encephalitis090.42 Congenital syphilitic meningitis090.49 Juvenile neurosyphilis, other090.5 Other late congenital syphilis, symptomatic090.6 Late congenital syphilis, latent090.7 Late congenital syphilis, unspecified090.9 Congenital syphilis, unspecified091.0 Genital syphilis (primary)091.1 Primary anal syphilis091.2 Other primary syphilis091.3 Secondary syphilis of skin or mucous membranes091.4 Adenopathy due to secondary syphilis091.50 Syphilitic uveitis, unspecified091.51 Syphilitic chorioretinitis (secondary)091.52 Syphilitic iridocyclitis (secondary)091.61 Secondary syphilitic periostitis091.62 Secondary syphilitic hepatitis091.69 Secondary syphilis of viscera and bone, other viscera091.7 Secondary syphilis, relapse091.81 Acute syphilitic meningitis (secondary)091.82 Syphilitic alopecia091.89 Other forms of secondary syphilis, other091.9 Unspecified secondary syphilis092.0 Early syphilis, latent, serological relapse after treatment092.9 Early syphilis, latent, unspecified093.0 Aneurysm of aorta, specified as syphilitic093.1 Syphilitic aortitis093.20 Syphilitic endocarditis; valve, unspecified093.21 Syphilitic endocarditis; mitral valve093.22 Syphilitic endocarditis; aortic valve093.23 Syphilitic endocarditis; tricuspid valve093.24 Syphilitic endocarditis; pulmonary valve093.81 Syphilitic pericarditis093.82 Syphilitic myocarditis53

Code:Description:093.89 Other specified cardiovascular syphilis, other093.9 Cardiovascular syphilis, unspecified094.0 Tabes dorsalis094.1 General paresis094.2 Syphilitic meningitis094.3 Asymptomatic neurosyphilis094.81 Syphilitic encephalitis094.82 Syphilitic Parkinsonism094.83 Syphilitic disseminated retinochoroiditis094.84 Syphilitic optic atrophy094.85 Syphilitic retrobulbar neuritis094.86 Syphilitic acoustic neuritis094.87 Syphilitic ruptured cerebral aneurysm094.89 Other specified neurosyphilis, other094.9 Neurosyphilis, unspecified095.0 Syphilitic episcleritis095.1 Syphilis of lung095.2 Syphilitic peritonitis095.3 Syphilis of liver095.4 Syphilis of kidney095.5 Syphilis of bone095.6 Syphilis of muscle095.7 Syphilis of synovium, tendon, and bursa095.8 Other specified forms of late symptomatic syphilis095.9 Late symptomatic syphilis, unspecified096 Late syphilis, latent097.0 Late syphilis, unspecified097.1 Latent syphilis, unspecified097.9 Syphilis, unspecified098.0 Gonococcal infections; acute, of lower genitourinary tract098.10 Gonococcal infection (acute) of upper genitourinary tract, unspecified098.11 Gonococcal cystitis (acute)098.12 Gonococcal prostatitis (acute)098.13 Gonococcal epididymo-orchitis (acute)098.14 Gonococcal seminal vesiculitis (acute)098.15 Gonococcal cervicitis (acute)098.16 Gonococcal endometritis (acute)098.17 Gonococcal salpingitis, specified as acute098.19 Other gonococcal infection of lower genitourinary tract098.2 Gonococcal infections; chronic, of lower genitourinary tract098.30 Chronic gonococcal infection of upper genitourinary tract, site unspecified098.31 Gonococcal cystitis, chronic098.32 Gonococcal prostatitis, chronic098.33 Gonococcal epididymo-orchitis, chronic098.34 Gonococcal seminal vesiculitis, chronic098.35 Gonococcal cervicitis, chronic098.36 Gonococcal endometritis chronic098.37 Gonococcal salpingitis (chronic)098.39 Gonococcal infections; chronic, of upper genitourinary tract, other098.40 Gonococcal conjunctivitis (neonatorum)098.41 Gonococcal iridocyclitis098.42 Gonococcal endophthalmia098.43 Gonococcal keratitis098.49 Gonococcal infection of eye, other098.50 Gonococcal arthritis54

Code:Description:098.51 Gonococcal synovitis and tenosynovitis098.52 Gonococcal bursitis098.53 Gonococcal spondylitis098.59 Gonococcal infection of joint, other098.6 Gonococcal infection of pharynx098.7 Gonococcal infection of anus and rectum098.81 Gonococcal keratosis (blennorrhagica)098.82 Gonococcal meningitis098.83 Gonococcal pericarditis098.84 Gonococcal endocarditis098.85 Other gonococcal heart disease098.86 Gonococcal peritonitis098.89 Gonococcal infection of other specified sites, other099.0 Chancroid099.1 Lymphogranuloma venereum099.2 Granuloma inguinale099.3 Reiter's disease099.40-099.49 Other nongonococcal urethritis [NGU]099.50-099.59 Other venereal diseases due to Chlamydia trachomatis099.8 Other specified venereal diseases099.9 Venereal disease, unspecified104.0 Nonvenereal endemic syphilis131.00 Urogenital trichomoniasis, unspecified131.01 Trichomonal vulvovaginitis131.02 Trichomonal urethritis131.03 Trichomonal prostatitis131.09 Urogenital trichomoniasis, other131.8 Urogenital trichomoniasis, other specified sites131.9 Trichomoniasis, unspecified331.0 Alzheimer's disease331.2 Senile degeneration of brain356.0 Hereditary peripheral neuropathy356.9 Hereditary and idiopathic peripheral neuropathy, unspecified364.3 Unspecified iridocyclitis388.2 Sudden hearing loss, unspecified389.10 Sensorineural hearing loss, unspecified389.11 Sensory hearing loss389.12 Neural hearing loss389.14 Central hearing loss389.18 Sensorineural hearing loss of combined types389.2 Mixed conductive and sensorineural hearing loss389.8 Other specified forms of hearing loss389.9 Unspecified hearing loss614.0 Acute salpingitis and oophoritis614.1 Chronic salpingitis and oophoritis614.2 Salpingitis and oophoritis not specified as acute, subacute, or chronic614.3 Acute parametritis and pelvic cellulitis614.4 Chronic or unspecified parametritis and pelvic cellulitis614.5 Acute or unspecified pelvic peritonitis, female614.6 Pelvic peritoneal adhesions, female (postoperative) (postinfection)614.7 Other chronic pelvic peritonitis, female614.8 Other specified inflammatory disease of female pelvic organs and tissues614.9 Unspecified inflammatory disease of female pelvic organs and tissues615.0 Inflammatory diseases of uterus, except cervix, acute615.1 Inflammatory diseases of uterus, except cervix, chronic55

Code:Description:615.9 Unspecified inflammatory disease of uterus616.0 Cervicitis and endocervicitis616.10 Vaginitis and vulvovaginitis, unspecified616.11 Vaginitis and vulvovaginitis in diseases classified elsewhere616.2 Cyst of Bartholin's gland616.3 Abscess of Bartholin's gland616.4 Other abscess of vulva616.50 Ulceration of vulva, unspecified616.51 Ulceration of vulva in diseases classified elsewhere616.8 Other specified inflammatory diseases of cervix, vagina, and vulva616.9 Unspecified inflammatory disease of cervix, vagina, and vulva696.3 Pityriasis rosea704.00 Alopecia, unspecified704.01 Alopecia areata709.9 Unspecified disorder of skin and subcutaneous tissue760.2 Maternal infections780.4 Dizziness and giddiness780.99 Other general symptoms781.2 Abnormality of gaitV01.6 Contact with or exposure to communicable diseases; venereal diseases56

Thyroid Testing (Total T 4 ,Free T 4 , TSH, T 3 or T 4 Uptake)CPT CODE: 84436 84439 8444384479ICD-9-CM Codes Covered by Medicare Program:Code:Description:017.50-017.56 Tuberculosis of the thyroid gland183.0 Malignant neoplasm of ovary193 Malignant neoplasm of thyroid gland194.8 Malignant neoplasm of other endocrine glands and related structures, other198.89 Secondary malignant neoplasm of the thyroid220 Benign neoplasm of ovary226 Benign neoplasm of thyroid gland227.3 Benign neoplasm of pituitary gland and craniopharyngeal duct234.8 Carcinoma in situ of other and unspecified sites237.4 Neoplasm of uncertain behavior of other and unspecified endocrine glands239.7 Neoplasm of unspecified nature, thyroid gland240.0-240.9 Goiter specified and unspecified241.0-241.9 Nontoxic nodular goiter242.00-242.91 Hypothyroidism243 Congenital hypothyroidism244.0-244.9 Acquired hypothyroidism245.0-245.9 Thyroiditis246.0-246.9 Other disorders of thyroid250.00-250.93 Diabetes mellitus252.1 Hypoparathyroidism253.1 Other and unspecified anterior pituitary hyper function253.2 Panhypopituitarism253.3 Pituitary dwarfism253.4 Other anterior pituitary disorders253.7 Iatrogenic pituitary disorders255.2 Adrenogenital disorders255.4 Corticoadrenal insufficiency256.31-256.39 Ovarian failure257.2 Testicular hypofunction258.0-258.9 Polyglandular dysfunction262 Malnutrition, severe263.0-263.9 Malnutrition, other and unspecified266.0 Ariboflavinosis272.0 Pure hypercholesterolemia272.2 Mixed hyperlipidemia272.4 Other and unspecified hyperlipidemia275.40-275.49 Calcium disorders276.0 Hyposmolality and/or hypernatremia276.1 Hyposmolality and/or hyponatremia278.3 Hypercarotenemia279.4 Autoimmune disorder, not classified elsewhere281.0 Pernicious anemia281.9 Unspecified deficiency anemia283.0 Autoimmune hemolytic anemia285.9 Anemia, unspecified290.0 Senile dementia, uncomplicated57

Code:Description:290.10-290.13 Presenile dementia290.20-290.21 Senile dementia with delusional or depressive features290.3 Senile dementia with delirium293.0-293.1 Delirium293.81-293.89 Transient organic mental disorders294.8 Other specified organic brain syndromes296.00-296.99 Affective psychoses297.0 Paranoid state, simple297.1 Paranoia297.9 Unspecified paranoid state298.3 Acute paranoid reaction300.00-300.09 Anxiety states307.9 Agitation - other and unspecified special symptoms or syndromes, not elsewhere classified310.1 Organic personality syndrome311 Depressive disorder, not elsewhere classified331.0-331.2 Alzheimer’s, pick’s disease, Senile degeneration of brain333.1 Essential and other specified forms of tremor333.99 Other extrapyramidal diseases and abnormal movement disorders354.0 Carpal Tunnel syndrome356.9 Idiopathic peripheral neuropathy, unspecified polyneuropathy358.1 Myasthenic syndromes in diseases classified elsewhere359.5 Myopathy in endocrine diseases classified elsewhere359.9 Myopathy, unspecified368.2 Diplopia372.71 Conjunctival hyperemia372.73 Conjunctival edema374.41 Lid retraction or lag374.82 Eyelid edema376.21 Thyrotoxic exophthalmos376.22 Exophthalmic ophthalmoplegia376.30-376.31 Exophthalmic conditions, unspecified and constant376.33-376.34 Orbital edema or congestion, intermittent exophthalmos378.50-378.55 Paralytic strabismus401.0-401.9 Essential hypertension403.00-403.91 Hypertensive renal disease404.00-404.93 Hypertensive heart and renal disease423.9 Unspecified disease of pericardium425.7 Nutritional and metabolic cardiomyopathy427.0 Paroxysmal supraventricular tachycardia427.2 Paroxysmal tachycardia, unspecified427.31 Atrial fibrillation427.89 Other specified cardiac dysrhythmia427.9 Cardiac dysrhythmia, unspecified428.0 Congestive heart failure, unspecified428.1 Left heart failure429.3 Cardiomegaly511.9 Unspecified pleural effusion518.81 Acute respiratory failure529.8 Other specified conditions of the tongue560.1 Paralytic ileus564.00-564.09 Constipation564.7 Megacolon, other than Hirschsprung’s568.82 Peritoneal effusion (chronic)58

Code:Description:625.3 Dysmenorrhea626.0-626.2 Disorders of menstruation626.4 Irregular menstrual cycle648.10-648.14 Other current conditions in the mother, classifiable elsewhere, but complicating pregnancy,childbirth, or the puerperium, thyroid dysfunction676.20-676.24 Engorgement of breast associated with childbirth and disorders of lactation698.9 Unspecified pruritic disorder701.1 Keratoderma, acquired (dry skin)703.8 Other specified diseases of nail (Brittle nails)704.00-704.09 Alopecia709.01 Vitiligo710.0-710.9 Diffuse disease of connective tissue728.2 Muscle wasting728.9 Unspecified disorder of muscle, ligament, and fascia729.1 Myalgia and myositis, unspecified729.82 Musculoskeletal cramp730.30-730.39 Periostitis without osteomyelitis733.09 Osteoporosis, drug induced750.15 Macroglossia, congenital759.2 Anomaly of other endocrine glands780.01 Coma780.02 Transient alteration of awareness780.09 Alteration of consciousness, other780.50-780.52 Insomnia780.6 Fever780.71-780.79 Malaise and fatigue780.8 Hyperhidrosis780.99 Other general symptoms781.0 Abnormal involuntary movements781.3 Lack of coordination, ataxia782.0 Disturbance of skin sensation782.3 Localized edema782.8 Changes in skin texture782.9 Other symptoms involving skin and integumentary tissues783.1 Abnormal weight gain783.21 Abnormal loss of weight783.6 Polyphagia784.1 Throat pain784.49 Voice disturbance784.5 Other speech disturbance785.0 Tachycardia, unspecified785.1 Palpitations785.9 Other symptoms involving cardiovascular system786.09 Other symptoms involving respiratory system786.1 Stridor787.2 Dysphagia787.91-787.99 Other symptoms involving digestive system789.5 Ascites793.9 Nonspecific abnormal findings on radiological and other examination, other (neck)794.5 Thyroid, abnormal scan or uptake796.1 Other nonspecific abnormal findings, abnormal reflex799.2 Nervousness990 Effects of radiation, unspecified59

Code:Description:V10.87 Personal history of malignant neoplasm of the thyroidV10.88 Personal history of malignant neoplasm of other endocrine glandV12.2 Personal history of endocrine, metabolic and immunity disordersV58.69 Long term (current) use of other medicationsV67.00-V67.9 Follow-up examination60

Tumor Antigen by Immunoassay - CA125 CPT CODE: 86304ICD-9-CM Codes Covered by Medicare Program:Code: Description:180.0 Malignant neoplasm, endocervix182.0 Malignant neoplasm of corpus uteri, except isthmus183.0 Malignant neoplasm,ovary183.2 Malignant neoplasm, fallopian tube183.8 Malignant neoplasm, other specified sites of uterine adnexa184.8 Malignant neoplasm, other specified sites of female genital organs198.6 Secondary malignant neoplasm, ovary198.82 Secondary malignancy of genital organs236.0-236.3 Neoplasm of uncertain behavior of female genital organsV10.43-V10.44 Personal history of malignant neoplasm of female genital organs61

Tumor Antigen by Immunoassay CA 15-3/CA27.29CPT CODE:86300ICD-9-CM Codes Covered by Medicare Program:Code:Description:174.0-174.9 Breast, primary (female) – malignant neoplasm of female breast175.0-175.9 Breast, primary (male) – malignant neoplasm of male breast198.2 Secondary malignant neoplasm (breast)198.81 Secondary malignant neoplasm (breast)V10.3 Personal history of malignant neoplasm, breast62

Tumor Antigen by Immunoassay CA 19-9 CPT CODE: 86301ICD-9-CM Codes Covered by Medicare Program:Code:Description:155.1 Malignant neoplasm, intrahepatic bile ducts156.1 Malignant neoplasm, extrahepatic bile ducts156.8 Malignant neoplasm, other specified sites of gallbladder and extrahepatic bile ducts156.9 Malignant neoplasm, unspecified part of biliary tract157.0-157.9 Malignant neoplasm, pancreas197.8 Secondary malignant neoplasm, other digestive organs and spleen235.3 Neoplasm of uncertain behavior, liver and biliary passages235.5 Neoplasm of uncertain behavior, other and unspecified digestive organsV10.09 Other personal history of cancerRevised July 2003* The policies for these tests give guidelines for allowed frequency of testing. Most are not definitive but aredependent on the patient’s diagnoses. It is important to remember the following simplified guidelines.Blood Glucose .....................................................................................Not more than every 3 monthsGlycated Hemoglobin ........................................................................Not more than every 3 monthsLipid Panel ..........................................................................................AnnuallyDirect LDL or Total Cholesterol for Monitoring Treatment ......Up to 6 times per yearThyroid Testing Up to 2 times per year for patients with normal thyroid function63