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2012AA Healthcare Common Procedure Coding System Source Information

Counts

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Attribute Name Description Count (MRSAT.RRF)
HTS HCPCS Type of Service Code - carrier assigned HCFA Type of Service which describes the particular kind(s) of service represented by the procedure code. 7485
HAC HCPCS action code - code denoting the change made to a procedure or modifier code within the HCPCS system. 5821
HAQ HCPCS Anesthesia Base Unit Quantity - base unit represents the level of intensity for anesthesia procedure services that reflects all activities except time. 5821
HCC HCPCS Coverage Code - code denoting Medicare coverage status. There are two subelements separated by "=". 5821
HCD HCPCS Code Added Date - year the HCPCS code was added to the HCFA Common Procedure Coding System. 5821
HAD HCPCS Action Effective Date - effective date of action to a procedure or modifier code. 5820
HPI HCPCS Pricing Indicator Code - used to identify the appropriate methodology for developing unique pricing amounts under Part B. 5509
HBT HCPCS Berenson-Eggers Type of Service Code - BETOS for the procedure code based on generally agreed upon clinically meaningful groupings of procedures and services. 5507
HMP HCPCS Multiple Pricing Indicator Code - code used to identify instances where a procedure could be priced. 5507
HMR HCPCS Medicare Carriers Manual reference section number - number identifying a section of the Medicare Carriers Manual. 1185
HPN HCPCS processing note number identifying the processing note contained in Appendix A of the HCPCS Manual. 697
HIR HCPCS Coverage Issues Manual Reference Section Number - number identifying the Reference Section of the Coverage Issues Manual. 514
HTD HCPCS Termination Date - last date for which a procedure or code may be used by Medicare Providers. 513
HPD HCPCS ASC payment group effective date - date the procedure is assigned to the ASC payment group. 394
HPG HCPCS ASC payment group code which represents the dollar amount of the facility charge payable by Medicare for the procedure. 394
HSN HCPCS Statute Number identifying statute reference for coverage or noncoverage of procedure or service. 377
HXR HCPCS Cross reference code - an explicit reference crosswalking a deleted code or a code that is not valid for Medicare to a valid current code (or range of codes). 105
HLC HCPCS Lab Certification Code - code used to classify laboratory procedures according to the specialty certification categories listed by CMS(formerly HCFA). 34

Notes

  • Attributes included every discrete piece of information about a concept, an atom, or a relationship that is not part of the basic Metathesaurus concept structure or distributed in one of the relationship files.
  • Attribute Names (ATN) are based on source documentation or NLMs understanding of the source.
  • Sample attribute values (ATV) are provided for each ATN in the source.
  • Sample data highlight examples of ATNs and Attribute Values (ATV) in MRSAT.RRF.
  • See Metathesaurus Documentation for a complete list of attribute names.
  • See Section 2.5 of the UMLS Reference Manual for more information on attributes in the UMLS Metathesaurus.

Sample Data

HTS

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CUI METAUI LUI SUI STYPE CODE ATN ATV STR
C0497715 A2411614 L2342479 S2776168 SCUI A0100 HTS D=Ambulance (eff 04/95) NON-EMERGENCY TRANSPORTATION; TAXI
C0497955 A1017321 L0667408 S0960934 SCUI A5093 HTS P=Lump sum purchase of DME, prosthetics, orthotics OSTOMY ACCESSORY; CONVEX INSERT
C0520028 A0981383 L0834050 S0924534 SCUI A5114 HTS P=Lump sum purchase of DME, prosthetics, orthotics LEG STRAP; FOAM OR FABRIC, REPLACEMENT ONLY, PER SET
C0500160 A9063221 L1218296 S1459885 SCUI A6539 HTS P=Lump sum purchase of DME, prosthetics, orthotics GRADIENT COMPRESSION STOCKING, WAIST LENGTH, 18-30 MMHG, EACH
C0919089 A9064362 L5670966 S6503426 SCUI A6550 HTS P=Lump sum purchase of DME, prosthetics, orthotics WOUND CARE SET, FOR NEGATIVE PRESSURE WOUND THERAPY ELECTRICAL PUMP, INCLUDES ALL SUPPLIES AND ACCESSORIES
C1144996 A2411680 L2341946 S2776224 SCUI A7044 HTS R=Rental of DME ORAL INTERFACE USED WITH POSITIVE AIRWAY PRESSURE DEVICE, EACH
C0993735 A7184689 L2046461 S2383492 SCUI C1724 HTS 9=Other medical items or services CATHETER, TRANSLUMINAL ATHERECTOMY, ROTATIONAL
C0993779 A7184755 L2046774 S2385269 SCUI C1874 HTS 9=Other medical items or services STENT, COATED/COVERED, WITH DELIVERY SYSTEM
C0993783 A7184732 L2046829 S2384643 SCUI C1878 HTS S=Surgical dressings or other medical supplies (eff 04/95) MATERIAL FOR VOCAL CORD MEDIALIZATION, SYNTHETIC (IMPLANTABLE)
C0993786 A7184663 L2046633 S2383378 SCUI C1882 HTS 9=Other medical items or services CARDIOVERTER-DEFIBRILLATOR, OTHER THAN SINGLE OR DUAL CHAMBER (IMPLANTABLE)
C0993816 A7184672 L2045929 S2383455 SCUI C2630 HTS 9=Other medical items or services CATHETER, ELECTROPHYSIOLOGY, DIAGNOSTIC/ABLATION, OTHER THAN 3D OR VECTOR MAPPING, COOL-TIP
C0498427 A0955425 L0737308 S0898459 SCUI E0292 HTS R=Rental of DME HOSPITAL BED, VARIABLE HEIGHT, HI-LO, WITHOUT SIDE RAILS, WITH MATTRESS
C0498445 A1039098 L0679752 S0981218 SCUI E0435 HTS R=Rental of DME PORTABLE LIQUID OXYGEN SYSTEM, PURCHASE; INCLUDES PORTABLE CONTAINER, SUPPLY RESERVOIR, FLOWMETER, HUMIDIFIER, CONTENTS GAUGE, CANNULA OR MASK, TUBING AND REFILL ADAPTOR
C0498458 A1414207 L1219435 S1461173 SCUI E0460 HTS R=Rental of DME NEGATIVE PRESSURE VENTILATOR; PORTABLE OR STATIONARY
C0812700 A1751945 L1506138 S1800349 SCUI E0616 HTS 9=Other medical items or services IMPLANTABLE CARDIAC EVENT RECORDER WITH MEMORY, ACTIVATOR AND PROGRAMMER
C0918992 A1947653 L1776510 S2072350 SCUI E0617 HTS R=Rental of DME EXTERNAL DEFIBRILLATOR WITH INTEGRATED ELECTROCARDIOGRAM ANALYSIS
C1145092 A2412463 L2341677 S2776932 SCUI E0693 HTS R=Rental of DME ULTRAVIOLET LIGHT THERAPY SYSTEM PANEL, INCLUDES BULBS/LAMPS, TIMER AND EYE PROTECTION, 6 FOOT PANEL
C1508919 A7185583 L5316495 S6058309 SCUI E0769 HTS 9=Other medical items or services ELECTRICAL STIMULATION OR ELECTROMAGNETIC WOUND TREATMENT DEVICE, NOT OTHERWISE CLASSIFIED
C1508920 A7185331 L5316363 S6057911 SCUI E0849 HTS R=Rental of DME TRACTION EQUIPMENT, CERVICAL, FREE-STANDING STAND/FRAME, PNEUMATIC, APPLYING TRACTION FORCE TO OTHER THAN MANDIBLE

HAC

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CUI METAUI LUI SUI STYPE CODE ATN ATV STR
C0497640 A0912236 L0770882 S0853864 SCUI KJ HAC N=No maintenance for this code DMEPOS ITEM, PARENTERAL ENTERAL NUTRITION (PEN) PUMP OR CAPPED RENTAL, MONTHS FOUR TO FIFTEEN
C1144890 A2411187 L2342579 S2775758 SCUI TT HAC N=No maintenance for this code INDIVIDUALIZED SERVICE PROVIDED TO MORE THAN ONE PATIENT IN SAME SETTING
C0497702 A0850014 L0712302 S0790651 SCUI VP HAC N=No maintenance for this code APHAKIC PATIENT
C1314219 A3861870 L3155498 S3677837 SCUI A4366 HAC N=No maintenance for this code OSTOMY VENT, ANY TYPE, EACH
C1314236 A3861314 L2341540 S2776264 SCUI A4434 HAC N=No maintenance for this code OSTOMY POUCH, URINARY; FOR USE ON BARRIER WITH LOCKING FLANGE, WITH FAUCET-TYPE TAP WITH VALVE (2 PIECE), EACH
C1144955 A2411682 L2342013 S2776226 SCUI A4931 HAC N=No maintenance for this code ORAL THERMOMETER, REUSABLE, ANY TYPE, EACH
C0497943 A2411713 L2341442 S2776255 SCUI A5061 HAC N=No maintenance for this code OSTOMY POUCH, DRAINABLE; WITH BARRIER ATTACHED, (1 PIECE), EACH
C1144977 A2410551 L2342207 S2775165 SCUI A6507 HAC N=No maintenance for this code COMPRESSION BURN GARMENT, FOOT TO KNEE LENGTH, CUSTOM FABRICATED
C0499315 A1413486 L1218754 S1460403 SCUI A7035 HAC N=No maintenance for this code HEADGEAR USED WITH POSITIVE AIRWAY PRESSURE DEVICE
C0499318 A1413484 L1218753 S1460402 SCUI A7038 HAC N=No maintenance for this code FILTER, DISPOSABLE, USED WITH POSITIVE AIRWAY PRESSURE DEVICE
C0993759 A7184709 L2046778 S2384368 SCUI C1770 HAC N=No maintenance for this code IMAGING COIL, MAGNETIC RESONANCE (INSERTABLE)
C0080306 A7184765 L0080306 S2385506 SCUI C1880 HAC N=No maintenance for this code VENA CAVA FILTER
C0993788 A7184686 L2046359 S2383489 SCUI C1885 HAC N=No maintenance for this code CATHETER, TRANSLUMINAL ANGIOPLASTY, LASER
C0993789 A7184674 L2046626 S2383460 SCUI C1887 HAC N=No maintenance for this code CATHETER, GUIDING (MAY INCLUDE INFUSION/PERFUSION CAPABILITY)
C0498356 A9064523 L5670960 S6503648 SCUI E0116 HAC N=No maintenance for this code CRUTCH, UNDERARM, OTHER THAN WOOD, ADJUSTABLE OR FIXED, WITH PAD, TIP, HANDGRIP, WITH OR WITHOUT SHOCK ABSORBER, EACH
C0498388 A0954015 L0822907 S0895875 SCUI E0191 HAC N=No maintenance for this code HEEL OR ELBOW PROTECTOR, EACH
C0498396 A1118906 L0783638 S1061047 SCUI E0217 HAC N=No maintenance for this code WATER CIRCULATING HEAT PAD WITH PUMP
C1314293 A3862455 L3155492 S3678402 SCUI E0240 HAC N=No maintenance for this code BATH/SHOWER CHAIR, WITH OR WITHOUT WHEELS, ANY SIZE
C0498415 A0955424 L0711407 S0898458 SCUI E0256 HAC N=No maintenance for this code HOSPITAL BED, VARIABLE HEIGHT, HI-LO, WITH ANY TYPE SIDE RAILS, WITHOUT MATTRESS

HAQ

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CUI METAUI LUI SUI STYPE CODE ATN ATV STR
C0497675 A0912359 L0648635 S0853998 SCUI QP HAQ 0 DOCUMENTATION IS ON FILE SHOWING THAT THE LABORATORY TEST(S) WAS ORDERED INDIVIDUALLY OR ORDERED AS A CPT-RECOGNIZED PANEL OTHER THAN AUTOMATED PROFILE CODES 80002-80019, G0058, G0059, AND G0060.
C0497681 A0888795 L0654042 S0830582 SCUI QX HAQ 0 CRNA SERVICE: WITH MEDICAL DIRECTION BY A PHYSICIAN
C0497814 A0964579 L0738843 S0907681 SCUI A4313 HAQ 0 INSERTION TRAY WITHOUT DRAINAGE BAG WITH INDWELLING CATHETER, FOLEY TYPE, THREE-WAY, FOR CONTINUOUS IRRIGATION
C0812606 A1753291 L1506582 S1801620 SCUI A4378 HAQ 0 OSTOMY POUCH, DRAINABLE, FOR USE ON FACEPLATE, RUBBER, EACH
C0520182 A0948333 L0627208 S0889828 SCUI A6216 HAQ 0 GAUZE, NON-IMPREGNATED, NON-STERILE, PAD SIZE 16 SQ. IN. OR LESS, WITHOUT ADHESIVE BORDER, EACH DRESSING
C0520075 A0948339 L0627209 S0889836 SCUI A6402 HAQ 0 GAUZE, NON-IMPREGNATED, STERILE, PAD SIZE 16 SQ. IN. OR LESS, WITHOUT ADHESIVE BORDER, EACH DRESSING
C0500164 A9063240 L1219001 S1460683 SCUI A6544 HAQ 0 GRADIENT COMPRESSION STOCKING, GARTER BELT
C0878980 A7184681 L2046723 S2383469 SCUI C1753 HAQ 0 CATHETER, INTRAVASCULAR ULTRASOUND
C0993766 A7184727 L2047145 S2384577 SCUI C1779 HAQ 0 LEAD, PACEMAKER, TRANSVENOUS VDD SINGLE PASS
C0993777 A7184754 L2046861 S2385208 SCUI C1817 HAQ 0 SEPTAL DEFECT IMPLANT SYSTEM, INTRACARDIAC
C0993782 A7184758 L2046773 S2385281 SCUI C1877 HAQ 0 STENT, NON-COATED/NON-COVERED, WITHOUT DELIVERY SYSTEM
C1145021 A2411935 L2342418 S2776456 SCUI C2614 HAQ 0 PROBE, PERCUTANEOUS LUMBAR DISCECTOMY
C0993813 A7184711 L2047092 S2384403 SCUI C2626 HAQ 0 INFUSION PUMP, NON-PROGRAMMABLE, TEMPORARY (IMPLANTABLE)
C0993844 A2232199 L2047112 S2384443 SCUI C9113 HAQ 0 INJECTION, PANTOPRAZOLE SODIUM, PER VIAL
C0498386 A1077779 L0878235 S1020803 SCUI E0188 HAQ 0 SYNTHETIC SHEEPSKIN PAD
C1314299 A3861143 L2045921 S2384271 SCUI E0303 HAQ 0 HOSPITAL BED, HEAVY DUTY, EXTRA WIDE, WITH WEIGHT CAPACITY GREATER THAN 350 POUNDS, BUT LESS THAN OR EQUAL TO 600 POUNDS, WITH ANY TYPE SIDE RAILS, WITH MATTRESS
C0498435 A0873536 L0667337 S0813769 SCUI E0315 HAQ 0 BED ACCESSORY: BOARD, TABLE, OR SUPPORT DEVICE, ANY TYPE
C0498564 A0850872 L0720141 S0791564 SCUI E0994 HAQ 0 ARM REST, EACH
C0498653 A2232632 L2046302 S2384938 SCUI E1540 HAQ 0 PRESSURE ALARM FOR HEMODIALYSIS, EACH, REPLACEMENT

HCC

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CUI METAUI LUI SUI STYPE CODE ATN ATV STR
C0497661 A1016687 L0736705 S0960150 SCUI Q9 HCC C=Carrier judgment ONE CLASS B AND TWO CLASS C FINDINGS
C0497664 A1075949 L0780545 S1018498 SCUI QC HCC C=Carrier judgment SINGLE CHANNEL MONITORING
C1144902 A2411486 L2341699 S2776042 SCUI U9 HCC I=Not payable by Medicare MEDICAID LEVEL OF CARE 9, AS DEFINED BY EACH STATE
C1144903 A2411476 L2341476 S2776032 SCUI UB HCC I=Not payable by Medicare MEDICAID LEVEL OF CARE 11, AS DEFINED BY EACH STATE
C0497719 A1008652 L0690415 S0952255 SCUI A0140 HCC I=Not payable by Medicare NON-EMERGENCY TRANSPORTATION AND AIR TRAVEL (PRIVATE OR COMMERCIAL) INTRA OR INTER STATE
C0497767 A2410906 L2341940 S2775495 SCUI A0424 HCC C=Carrier judgment EXTRA AMBULANCE ATTENDANT, GROUND (ALS OR BLS) OR AIR (FIXED OR ROTARY WINGED); (REQUIRES MEDICAL REVIEW)
C0918299 A1948883 L1776838 S2073761 SCUI A0434 HCC C=Carrier judgment SPECIALTY CARE TRANSPORT (SCT)
C1508779 A7184945 L5316386 S6057241 SCUI A4223 HCC C=Carrier judgment INFUSION SUPPLIES NOT USED WITH EXTERNAL INFUSION PUMP, PER CASSETTE OR BAG (LIST DRUGS SEPARATELY)
C0497794 A0848618 L0691797 S0788965 SCUI A4245 HCC C=Carrier judgment ALCOHOL WIPES, PER BOX
C1740778 A11002443 L6139753 S7050831 SCUI A4559 HCC C=Carrier judgment COUPLING GEL OR PASTE, FOR USE WITH ULTRASOUND DEVICE, PER OZ
C0497874 A0873402 L0741515 S0813564 SCUI A4611 HCC C=Carrier judgment BATTERY, HEAVY DUTY; REPLACEMENT FOR PATIENT OWNED VENTILATOR
C0497917 A2230968 L2045958 S2383142 SCUI A4774 HCC D=Special coverage instructions apply AMMONIA TEST STRIPS, FOR DIALYSIS, PER 50
C0993737 A7184665 L2046491 S2383436 SCUI C1726 HCC D=Special coverage instructions apply CATHETER, BALLOON DILATATION, NON-VASCULAR
C0182504 A7184745 L0220234 S2384961 SCUI C1813 HCC D=Special coverage instructions apply PROSTHESIS, PENILE, INFLATABLE
C0993783 A7184732 L2046829 S2384643 SCUI C1878 HCC D=Special coverage instructions apply MATERIAL FOR VOCAL CORD MEDIALIZATION, SYNTHETIC (IMPLANTABLE)
C0993787 A7184653 L2046102 S2383105 SCUI C1883 HCC D=Special coverage instructions apply ADAPTOR/EXTENSION, PACING LEAD OR NEUROSTIMULATOR LEAD (IMPLANTABLE)
C1145019 A2410496 L2341752 S2775113 SCUI C1888 HCC D=Special coverage instructions apply CATHETER, ABLATION, NON-CARDIAC, ENDOVASCULAR (IMPLANTABLE)
C0498369 A0888862 L0733685 S0830627 SCUI E0157 HCC C=Carrier judgment CRUTCH ATTACHMENT, WALKER, EACH
C0498371 A1075994 L0741398 S1018543 SCUI E0160 HCC D=Special coverage instructions apply SITZ TYPE BATH OR EQUIPMENT, PORTABLE, USED WITH OR WITHOUT COMMODE

HCD

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CUI METAUI LUI SUI STYPE CODE ATN ATV STR
C1144845 A2411298 L2342349 S2775859 SCUI AX HCD 20030101 ITEM FURNISHED IN CONJUNCTION WITH DIALYSIS SERVICES
C0497628 A0981998 L0631531 S0925461 SCUI K2 HCD 19930101 LOWER EXTREMITY PROSTHESIS FUNCTIONAL LEVEL 2 - HAS THE ABILITY OR POTENTIAL FOR AMBULATION WITH THE ABILITY TO TRAVERSE LOW LEVEL ENVIRONMENTAL BARRIERS SUCH AS CURBS, STAIRS OR UNEVEN SURFACES. TYPICAL OF THE LIMITED COMMUNITY AMBULATOR.
C0973441 A9064530 L1885744 S6503705 SCUI P5 HCD 20060101 A MORIBUND PATIENT WHO IS NOT EXPECTED TO SURVIVE WITHOUT THE OPERATION
C0497698 A0981350 L0841189 S0924500 SCUI TA HCD 19950101 LEFT FOOT, GREAT TOE
C1144904 A2411477 L2341483 S2776033 SCUI UC HCD 20020701 MEDICAID LEVEL OF CARE 12, AS DEFINED BY EACH STATE
C1144910 A2410226 L2341795 S2774858 SCUI A4282 HCD 20030101 ADAPTER FOR BREAST PUMP, REPLACEMENT
C1314223 A3861867 L3155128 S3677834 SCUI A4419 HCD 20040101 OSTOMY POUCH, CLOSED; FOR USE ON BARRIER WITH NON-LOCKING FLANGE, WITH FILTER (2 PIECE), EACH
C0993700 A2231119 L2045959 S2383304 SCUI A4770 HCD 19860101 BLOOD COLLECTION TUBE, VACUUM, FOR DIALYSIS, PER 50
C1144974 A2410555 L2342209 S2775169 SCUI A6504 HCD 20030101 COMPRESSION BURN GARMENT, GLOVE TO WRIST, CUSTOM FABRICATED
C1616802 A9063678 L5670608 S6502208 SCUI A9542 HCD 20060101 INDIUM IN-111 IBRITUMOMAB TIUXETAN, DIAGNOSTIC, PER STUDY DOSE, UP TO 5 MILLICURIES
C0993745 A7184677 L2046713 S2383465 SCUI C1751 HCD 20010401 CATHETER, INFUSION, INSERTED PERIPHERALLY, CENTRALLY OR MIDLINE (OTHER THAN HEMODIALYSIS)
C0993746 A11002620 L6139828 S7050763 SCUI C1752 HCD 20010401 CATHETER, HEMODIALYSIS/PERITONEAL, SHORT-TERM
C1314278 A3862088 L3155736 S3678050 SCUI C1814 HCD 20030401 RETINAL TAMPONADE DEVICE, SILICONE OIL
C0993828 A2232375 L2046352 S2384624 SCUI C8909 HCD 20011001 MAGNETIC RESONANCE ANGIOGRAPHY WITH CONTRAST, CHEST (EXCLUDING MYOCARDIUM)
C0182389 A0948447 L0845054 S0889949 SCUI E0196 HCD 19910101 GEL PRESSURE MATTRESS
C0498590 A1077033 L0719813 S1019865 SCUI E1130 HCD 19860101 STANDARD WHEELCHAIR, FIXED FULL LENGTH ARMS, FIXED OR SWING AWAY DETACHABLE FOOTRESTS
C0498620 A0954006 L0719805 S0895861 SCUI E1285 HCD 19860101 HEAVY DUTY WHEELCHAIR, FIXED FULL LENGTH ARMS, SWING AWAY DETACHABLE FOOTREST
C0498653 A2232632 L2046302 S2384938 SCUI E1540 HCD 19860101 PRESSURE ALARM FOR HEMODIALYSIS, EACH, REPLACEMENT
C1314331 A3861905 L3155666 S3677868 SCUI E1634 HCD 20040101 PERITONEAL DIALYSIS CLAMPS, EACH

HAD

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CUI METAUI LUI SUI STYPE CODE ATN ATV STR
C0497599 A2411295 L2341743 S2775856 SCUI AV HAD 20030101 ITEM FURNISHED IN CONJUNCTION WITH A PROSTHETIC DEVICE, PROSTHETIC OR ORTHOTIC
C0497619 A1062242 L0812594 S1004330 SCUI F9 HAD 19990101 RIGHT HAND, FIFTH DIGIT
C1144903 A2411476 L2341476 S2776032 SCUI UB HAD 20020701 MEDICAID LEVEL OF CARE 11, AS DEFINED BY EACH STATE
C0497801 A0980964 L0622671 S0924123 SCUI A4259 HAD 19960101 LANCETS, PER BOX OF 100
C1144912 A2410449 L2342177 S2775068 SCUI A4284 HAD 20070101 BREAST SHIELD AND SPLASH PROTECTOR FOR USE WITH BREAST PUMP, REPLACEMENT
C0497836 A0964574 L0738808 S0907676 SCUI A4354 HAD 19900101 INSERTION TRAY WITH DRAINAGE BAG BUT WITHOUT CATHETER
C1144950 A2412087 L2342196 S2776581 SCUI A4633 HAD 20030101 REPLACEMENT BULB/LAMP FOR ULTRAVIOLET LIGHT THERAPY SYSTEM, EACH
C0497891 A1061786 L0770575 S1003757 SCUI A4637 HAD 19960101 REPLACEMENT, TIP, CANE, CRUTCH, WALKER, EACH.
C1616804 A9064370 L5670550 S6503439 SCUI A9558 HAD 20060101 XENON XE-133 GAS, DIAGNOSTIC, PER 10 MILLICURIES
C1618911 A9064283 L5670710 S6503274 SCUI A9566 HAD 20060101 TECHNETIUM TC-99M FANOLESOMAB, DIAGNOSTIC, PER STUDY DOSE, UP TO 25 MILLICURIES
C0878939 A7184680 L1720599 S2383468 SCUI C1755 HAD 20040101 CATHETER, INTRASPINAL
C0993780 A7184756 L2046775 S2385270 SCUI C1875 HAD 20040101 STENT, COATED/COVERED, WITHOUT DELIVERY SYSTEM
C0492053 A9063873 L5670968 S6502523 SCUI E0971 HAD 20060101 MANUAL WHEELCHAIR ACCESSORY, ANTI-TIPPING DEVICE, EACH
C0498583 A0954512 L0719817 S0896670 SCUI E1089 HAD 20010401 HIGH STRENGTH LIGHTWEIGHT WHEELCHAIR, FIXED LENGTH ARMS, SWING AWAY DETACHABLE FOOTREST
C0993875 A2232786 L2046519 S2385106 SCUI E1821 HAD 20020101 REPLACEMENT SOFT INTERFACE MATERIAL/CUFFS FOR BI-DIRECTIONAL STATIC PROGRESSIVE STRETCH DEVICE
C1314340 A3861935 L3155319 S3677898 SCUI E2311 HAD 20040101 POWER WHEELCHAIR ACCESSORY, ELECTRONIC CONNECTION BETWEEN WHEELCHAIR CONTROLLER AND TWO OR MORE POWER SEATING SYSTEM MOTORS, INCLUDING ALL RELATED ELECTRONICS, INDICATOR FEATURE, MECHANICAL FUNCTION SELECTION SWITCH, AND FIXED MOUNTING HARDWARE
C0919095 A3861119 L1776613 S2073768 SCUI E2511 HAD 20040101 SPEECH GENERATING SOFTWARE PROGRAM, FOR PERSONAL COMPUTER OR PERSONAL DIGITAL ASSISTANT
C0993901 A2411862 L2342154 S2776384 SCUI G0219 HAD 20010701 PET IMAGING WHOLE BODY; MELANOMA FOR NON-COVERED INDICATIONS
C1314384 A3862591 L3155085 S3678534 SCUI H2011 HAD 20030401 CRISIS INTERVENTION SERVICE, PER 15 MINUTES

HPI

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CUI METAUI LUI SUI STYPE CODE ATN ATV STR
C0497722 A2412409 L2341987 S2776879 SCUI A0170 HPI 00=Service not separately priced by part B (e.g., services not covered, bundled, used by part a only, etc.) TRANSPORTATION ANCILLARY: PARKING FEES, TOLLS, OTHER
C0918290 A1947792 L1777226 S2072494 SCUI A0425 HPI 52=Reasonable charge GROUND MILEAGE, PER STATUTE MILE
C0993673 A1077789 L0636414 S1020813 SCUI A4207 HPI 00=Service not separately priced by part B (e.g., services not covered, bundled, used by part a only, etc.) SYRINGE WITH NEEDLE, STERILE 2CC, EACH
C0993700 A2231119 L2045959 S2383304 SCUI A4770 HPI 52=Reasonable charge BLOOD COLLECTION TUBE, VACUUM, FOR DIALYSIS, PER 50
C0497933 A2233147 L2046755 S2385507 SCUI A4918 HPI 52=Reasonable charge VENOUS PRESSURE CLAMP, FOR HEMODIALYSIS, EACH
C0520058 A1076061 L0711374 S1018625 SCUI A6250 HPI 00=Service not separately priced by part B (e.g., services not covered, bundled, used by part a only, etc.) SKIN SEALANTS, PROTECTANTS, MOISTURIZERS, OINTMENTS, ANY TYPE, ANY SIZE
C0499315 A1413486 L1218754 S1460403 SCUI A7035 HPI 32=Inexpensive and routinely purchased DME (price subject to floors and ceilings) HEADGEAR USED WITH POSITIVE AIRWAY PRESSURE DEVICE
C0498002 A1037029 L0675669 S0978570 SCUI B5000 HPI 39=Parenteral and enteral nutrition PARENTERAL NUTRITION SOLUTION: COMPOUNDED AMINO ACID AND CARBOHYDRATES WITH ELECTROLYTES, TRACE ELEMENTS, AND VITAMINS, INCLUDING PREPARATION, ANY STRENGTH, RENAL - AMIROSYN RF, NEPHRAMINE, RENAMINE - PREMIX
C0993792 A7184715 L2046473 S2384489 SCUI C1893 HPI 53=Statute INTRODUCER/SHEATH, GUIDING, INTRACARDIAC ELECTROPHYSIOLOGICAL, FIXED-CURVE, OTHER THAN PEEL-AWAY
C1314294 A3862282 L3155569 S3678231 SCUI E0247 HPI 00=Service not separately priced by part B (e.g., services not covered, bundled, used by part a only, etc.) TRANSFER BENCH FOR TUB OR TOILET WITH OR WITHOUT COMMODE OPENING
C0498506 A1752395 L1506298 S1800788 SCUI E0748 HPI 32=Inexpensive and routinely purchased DME (price subject to floors and ceilings) OSTEOGENESIS STIMULATOR, ELECTRICAL, NON-INVASIVE, SPINAL APPLICATIONS
C0498507 A1017253 L0824724 S0960858 SCUI E0749 HPI 36=Capped rental DME (price subject to floors and ceilings) OSTEOGENESIS STIMULATOR, ELECTRICAL, SURGICALLY IMPLANTED
C0498576 A0937860 L0719800 S0879824 SCUI E1070 HPI 36=Capped rental DME (price subject to floors and ceilings) FULLY-RECLINING WHEELCHAIR, DETACHABLE ARMS (DESK OR FULL LENGTH) SWING AWAY DETACHABLE FOOTREST
C0498677 A2231646 L2046137 S2383845 SCUI E1825 HPI 36=Capped rental DME (price subject to floors and ceilings) DYNAMIC ADJUSTABLE FINGER EXTENSION/FLEXION DEVICE, INCLUDES SOFT INTERFACE MATERIAL
C1314353 A3861948 L3155142 S3677911 SCUI E2340 HPI 32=Inexpensive and routinely purchased DME (price subject to floors and ceilings) POWER WHEELCHAIR ACCESSORY, NONSTANDARD SEAT FRAME WIDTH, 20-23 INCHES
C0919095 A3861119 L1776613 S2073768 SCUI E2511 HPI 32=Inexpensive and routinely purchased DME (price subject to floors and ceilings) SPEECH GENERATING SOFTWARE PROGRAM, FOR PERSONAL COMPUTER OR PERSONAL DIGITAL ASSISTANT
C1508937 A7185196 L5316072 S6057635 SCUI E2613 HPI 32=Inexpensive and routinely purchased DME (price subject to floors and ceilings) POSITIONING WHEELCHAIR BACK CUSHION, POSTERIOR, WIDTH LESS THAN 22 INCHES, ANY HEIGHT, INCLUDING ANY TYPE MOUNTING HARDWARE
C0812709 A1752928 L1506410 S1801295 SCUI G0102 HPI 11=Price established using national RVU's PROSTATE CANCER SCREENING; DIGITAL RECTAL EXAMINATION
C1145156 A2412036 L2341992 S2776540 SCUI G0288 HPI 11=Price established using national RVU's RECONSTRUCTION, COMPUTED TOMOGRAPHIC ANGIOGRAPHY OF AORTA FOR SURGICAL PLANNING FOR VASCULAR SURGERY

HBT

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CUI METAUI LUI SUI STYPE CODE ATN ATV STR
C0497719 A1008652 L0690415 S0952255 SCUI A0140 HBT O1A=Ambulance NON-EMERGENCY TRANSPORTATION AND AIR TRAVEL (PRIVATE OR COMMERCIAL) INTRA OR INTER STATE
C0497815 A0964576 L0738840 S0907678 SCUI A4314 HBT D1F=Prosthetic/Orthotic devices INSERTION TRAY WITH DRAINAGE BAG WITH INDWELLING CATHETER, FOLEY TYPE, TWO-WAY LATEX WITH COATING (TEFLON, SILICONE, SILICONE ELASTOMER OR HYDROPHILIC, ETC.)
C0812601 A2411732 L2341786 S2776272 SCUI A4373 HBT D1F=Prosthetic/Orthotic devices OSTOMY SKIN BARRIER, WITH FLANGE (SOLID, FLEXIBLE OR ACCORDIAN), WITH BUILT-IN CONVEXITY, ANY SIZE, EACH
C0497858 A0949116 L0848503 S0890883 SCUI A4470 HBT D1A=Medical/surgical supplies GRAVLEE JET WASHER
C0497861 A1077596 L0663503 S1020598 SCUI A4490 HBT D1A=Medical/surgical supplies SURGICAL STOCKINGS ABOVE KNEE LENGTH, EACH
C1144946 A2411748 L2342402 S2776287 SCUI A4606 HBT D1E=Other DME OXYGEN PROBE FOR USE WITH OXIMETER DEVICE, REPLACEMENT
C0497894 A9063682 L5670609 S6502212 SCUI A4642 HBT I1E=Standard imaging - nuclear medicine INDIUM IN-111 SATUMOMAB PENDETIDE, DIAGNOSTIC, PER STUDY DOSE, UP TO 6 MILLICURIES
C0520240 A0937436 L0803257 S0879362 SCUI A5507 HBT D1F=Prosthetic/Orthotic devices FOR DIABETICS ONLY, NOT OTHERWISE SPECIFIED MODIFICATION (INCLUDING FITTING) OF OFF-THE-SHELF DEPTH-INLAY SHOE OR CUSTOM-MOLDED SHOE, PER SHOE
C1144987 A9064524 L5671484 S6503653 SCUI A7032 HBT D1E=Other DME CUSHION FOR USE ON NASAL MASK INTERFACE, REPLACEMENT ONLY, EACH
C1144995 A2412501 L2342171 S2776970 SCUI A7043 HBT D1F=Prosthetic/Orthotic devices VACUUM DRAINAGE BOTTLE AND TUBING FOR USE WITH IMPLANTED CATHETER
C1508838 A7185107 L5316597 S6057493 SCUI A9153 HBT Z2=Undefined codes MULTIPLE VITAMINS, WITH OR WITHOUT MINERALS AND TRACE ELEMENTS, ORAL, PER DOSE, NOT OTHERWISE SPECIFIED
C0497978 A9064287 L5670737 S6503278 SCUI A9503 HBT I1E=Standard imaging - nuclear medicine TECHNETIUM TC-99M MEDRONATE, DIAGNOSTIC, PER STUDY DOSE, UP TO 30 MILLICURIES
C1145001 A9063781 L5670629 S6502310 SCUI A9517 HBT I1E=Standard imaging - nuclear medicine IODINE I-131 SODIUM IODIDE CAPSULE(S), THERAPEUTIC, PER MILLICURIE
C0520088 A7185643 L5315935 S6058368 SCUI B4152 HBT O1C=Enteral and parenteral ENTERAL FORMULA, NUTRITIONALLY COMPLETE, CALORICALLY DENSE (EQUAL TO OR GREATER THAN 1.5 KCAL/ML) WITH INTACT NUTRIENTS, INCLUDES PROTEINS, FATS, CARBOHYDRATES, VITAMINS AND MINERALS, MAY INCLUDE FIBER, ADMINISTERED THROUGH AN ENTERAL FEEDING TUBE, 100 CALORIES = 1 UNIT
C0498006 A0924470 L0691505 S0866067 SCUI B9002 HBT O1C=Enteral and parenteral ENTERAL NUTRITION INFUSION PUMP - WITH ALARM
C0993749 A7184683 L2046724 S2383476 SCUI C1756 HBT D1A=Medical/surgical supplies CATHETER, PACING, TRANSESOPHAGEAL
C0993768 A7184733 L2047097 S2384656 SCUI C1781 HBT D1A=Medical/surgical supplies MESH (IMPLANTABLE)
C0993773 A7184743 L2047090 S2384928 SCUI C1788 HBT D1A=Medical/surgical supplies PORT, INDWELLING (IMPLANTABLE)
C0993811 A7184746 L2047103 S2384963 SCUI C2622 HBT D1A=Medical/surgical supplies PROSTHESIS, PENILE, NON-INFLATABLE

HMP

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CUI METAUI LUI SUI STYPE CODE ATN ATV STR
C0812616 A2411704 L2341432 S2776246 SCUI A4389 HMP A=Not applicable as HCPCS priced under one methodology OSTOMY POUCH, DRAINABLE, WITH BARRIER ATTACHED, WITH BUILT-IN CONVEXITY (1 PIECE), EACH
C0812617 A1751543 L1505954 S1799975 SCUI A4390 HMP A=Not applicable as HCPCS priced under one methodology OSTOMY POUCH, DRAINABLE, WITH EXTENDED WEAR BARRIER ATTACHED, WITH BUILT-IN CONVEXITY (1 PIECE), EACH
C1314221 A3861287 L2341430 S2776234 SCUI A4417 HMP A=Not applicable as HCPCS priced under one methodology OSTOMY POUCH, CLOSED, WITH BARRIER ATTACHED, WITH BUILT-IN CONVEXITY, WITH FILTER (1 PIECE), EACH
C1314229 A3861303 L2341535 S2776254 SCUI A4427 HMP A=Not applicable as HCPCS priced under one methodology OSTOMY POUCH, DRAINABLE; FOR USE ON BARRIER WITH LOCKING FLANGE, WITH FILTER (2 PIECE SYSTEM), EACH
C0993689 A2231599 L2045875 S2383803 SCUI A4720 HMP A=Not applicable as HCPCS priced under one methodology DIALYSATE SOLUTION, ANY CONCENTRATION OF DEXTROSE, FLUID VOLUME GREATER THAN 249CC, BUT LESS THAN OR EQUAL TO 999CC, FOR PERITONEAL DIALYSIS
C0993704 A2232658 L2045964 S2384965 SCUI A4802 HMP A=Not applicable as HCPCS priced under one methodology PROTAMINE SULFATE, FOR HEMODIALYSIS, PER 50 MG
C0918334 A1947708 L1776198 S2072407 SCUI A7509 HMP A=Not applicable as HCPCS priced under one methodology FILTER HOLDER AND INTEGRATED FILTER HOUSING, AND ADHESIVE, FOR USE AS A TRACHEOSTOMA HEAT AND MOISTURE EXCHANGE SYSTEM, EACH
C1508838 A7185107 L5316597 S6057493 SCUI A9153 HMP 9=Not applicable as HCPCS not priced separately by part B (pricing indicator is 00) or value is not established (pricing indicator is '99') MULTIPLE VITAMINS, WITH OR WITHOUT MINERALS AND TRACE ELEMENTS, ORAL, PER DOSE, NOT OTHERWISE SPECIFIED
C0497978 A9064287 L5670737 S6503278 SCUI A9503 HMP A=Not applicable as HCPCS priced under one methodology TECHNETIUM TC-99M MEDRONATE, DIAGNOSTIC, PER STUDY DOSE, UP TO 30 MILLICURIES
C0918496 A1947890 L1775853 S2072614 SCUI C1300 HMP A=Not applicable as HCPCS priced under one methodology HYPERBARIC OXYGEN UNDER PRESSURE, FULL BODY CHAMBER, PER 30 MINUTE INTERVAL
C0182262 A1038447 L0745828 S0980257 SCUI E0202 HMP A=Not applicable as HCPCS priced under one methodology PHOTOTHERAPY (BILIRUBIN) LIGHT WITH PHOTOMETER
C0993858 A2231381 L2046298 S2383580 SCUI E0482 HMP A=Not applicable as HCPCS priced under one methodology COUGH STIMULATING DEVICE, ALTERNATING POSITIVE AND NEGATIVE AIRWAY PRESSURE
C1508918 A7185160 L5316217 S6057601 SCUI E0640 HMP 9=Not applicable as HCPCS not priced separately by part B (pricing indicator is 00) or value is not established (pricing indicator is '99') PATIENT LIFT, FIXED SYSTEM, INCLUDES ALL COMPONENTS/ACCESSORIES
C0498525 A0937716 L0733564 S0879652 SCUI E0920 HMP A=Not applicable as HCPCS priced under one methodology FRACTURE FRAME, ATTACHED TO BED, INCLUDES WEIGHTS
C0498537 A7185327 L5316356 S6057907 SCUI E0952 HMP 9=Not applicable as HCPCS not priced separately by part B (pricing indicator is 00) or value is not established (pricing indicator is '99') TOE LOOP/HOLDER, ANY TYPE, EACH
C0498588 A1075543 L0719810 S1017977 SCUI E1100 HMP A=Not applicable as HCPCS priced under one methodology SEMI-RECLINING WHEELCHAIR, FIXED FULL LENGTH ARMS, SWING AWAY DETACHABLE ELEVATING LEG RESTS
C0498666 A2232904 L2045717 S2385240 SCUI E1636 HMP A=Not applicable as HCPCS priced under one methodology SORBENT CARTRIDGES, FOR HEMODIALYSIS, PER 10
C1618858 A9063888 L5670984 S6502538 SCUI E2212 HMP A=Not applicable as HCPCS priced under one methodology MANUAL WHEELCHAIR ACCESSORY, TUBE FOR PNEUMATIC PROPULSION TIRE, ANY SIZE, EACH
C1739980 A11002266 L6139455 S7050171 SCUI E2395 HMP A=Not applicable as HCPCS priced under one methodology POWER WHEELCHAIR ACCESSORY, CASTER WHEEL EXCLUDES TIRE, ANY SIZE, REPLACEMENT ONLY, EACH

HMR

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CUI METAUI LUI SUI STYPE CODE ATN ATV STR
C0237412 A0887237 L0291782 S0828445 SCUI AH HMR 5112 CLINICAL PSYCHOLOGIST
C0497591 A0887239 L0785714 S0828447 SCUI AJ HMR 5113 CLINICAL SOCIAL WORKER
C0497625 A1098700 L0650092 S1041187 SCUI GE HMR 4116 THIS SERVICE HAS BEEN PERFORMED BY A RESIDENT WITHOUT THE PRESENCE OF A TEACHING PHYSICIAN UNDER THE PRIMARY CARE EXCEPTION
C0497671 A0992091 L0699597 S0935723 SCUI QK HMR 3350.5 MEDICAL DIRECTION OF TWO, THREE, OR FOUR CONCURRENT ANESTHESIA PROCEDURES INVOLVING QUALIFIED INDIVIDUALS
C0497797 A1110093 L0622853 S1052353 SCUI A4250 HMR 2100 URINE TEST OR REAGENT STRIPS OR TABLETS (100 TABLETS OR STRIPS)
C0497812 A0964580 L0738841 S0907682 SCUI A4311 HMR 2130 INSERTION TRAY WITHOUT DRAINAGE BAG WITH INDWELLING CATHETER, FOLEY TYPE, TWO-WAY LATEX WITH COATING (TEFLON, SILICONE, SILICONE ELASTOMER OR HYDROPHILIC, ETC.)
C0497826 A1037915 L0681047 S0979658 SCUI A4330 HMR 2130 PERIANAL FECAL COLLECTION POUCH WITH ADHESIVE, EACH
C0497837 A0965161 L0653313 S0908615 SCUI A4355 HMR 2130 IRRIGATION TUBING SET FOR CONTINUOUS BLADDER IRRIGATION THROUGH A THREE-WAY INDWELLING FOLEY CATHETER, EACH
C0497838 A0925381 L0736785 S0867177 SCUI A4356 HMR 2130 EXTERNAL URETHRAL CLAMP OR COMPRESSION DEVICE (NOT TO BE USED FOR CATHETER CLAMP), EACH
C0812604 A1752674 L1506333 S1801066 SCUI A4376 HMR 2130 OSTOMY POUCH, DRAINABLE, WITH FACEPLATE ATTACHED, RUBBER, EACH
C0812610 A1753305 L1506589 S1801635 SCUI A4382 HMR 2130 OSTOMY POUCH, URINARY, FOR USE ON FACEPLATE, HEAVY PLASTIC, EACH
C0812618 A2411716 L2341445 S2776258 SCUI A4391 HMR 2130 OSTOMY POUCH, URINARY, WITH EXTENDED WEAR BARRIER ATTACHED (1 PIECE), EACH
C1144921 A2411702 L2341527 S2776244 SCUI A4413 HMR 2130 OSTOMY POUCH, DRAINABLE, HIGH OUTPUT, FOR USE ON A BARRIER WITH FLANGE (2 PIECE SYSTEM), WITH FILTER, EACH
C0497862 A1077599 L0822944 S1020601 SCUI A4495 HMR 2079 SURGICAL STOCKINGS THIGH LENGTH, EACH
C0497864 A1077598 L0822933 S1020600 SCUI A4510 HMR 2079 SURGICAL STOCKINGS FULL LENGTH, EACH
C0497885 A1099520 L0760331 S1042114 SCUI A4626 HMR 2130 TRACHEOSTOMY CLEANING BRUSH, EACH
C0497902 A2230930 L2046097 S2383103 SCUI A4680 HMR 4270 ACTIVATED CARBON FILTER FOR HEMODIALYSIS, EACH
C0993694 A2410753 L2341642 S2775348 SCUI A4725 HMR 4270 DIALYSATE SOLUTION, ANY CONCENTRATION OF DEXTROSE, FLUID VOLUME GREATER THAN 4999CC BUT LESS THAN OR EQUAL TO 5999CC, FOR PERITONEAL DIALYSIS
C0497917 A2230968 L2045958 S2383142 SCUI A4774 HMR 4270 AMMONIA TEST STRIPS, FOR DIALYSIS, PER 50

HPN

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CUI METAUI LUI SUI STYPE CODE ATN ATV STR
C0497594 A1038485 L0870405 S0980394 SCUI AM HPN 0069=FOR ASSISTANT SURGEON SERVICES MODIFIERS 80, 81, 82, AK, AL, AM, AN, AS, AU, AV, AW, AY, QB, QU SEE MCM SECTION 15044. PHYSICIAN, TEAM MEMBER SERVICE
C1971590 A13298688 L6882426 S8012942 SCUI Q1 HPN 0146=NCD MANUAL, SECTION 310.1, 42 CFR 405.205, SUBPART B SECTION 1862(A) OF THE ACT. ROUTINE CLINICAL SERVICE PROVIDED IN A CLINICAL RESEARCH STUDY THAT IS IN AN APPROVED CLINICAL RESEARCH STUDY
C0497654 A0953853 L0808026 S0895675 SCUI Q2 HPN 0046=THIS MODIFIER (Q2) IS AUTHORIZED FOR USE BY THE HCFA OFFICE OF RESEARCH AND DEMONSTRATIONS ONLY; FOR CLAIMS SUBMITTED TO ORD FOR PAYMENT IN CONNECTION WITH DEMONSTRATION PROJECTS. HCFA/ORD DEMONSTRATION PROJECT PROCEDURE/SERVICE
C1618910 A9064260 L5670566 S6503208 SCUI A4218 HPN 0127=PUBLICATION 100.2, CHAPTER 15, 50.1. STERILE SALINE OR WATER, METERED DOSE DISPENSER, 10 ML
C0497787 A1061229 L0856238 S1003168 SCUI A4220 HPN 0050=THIS CODE MUST INCLUDE NON-CORING NEEDLES, PRESSURE MONITOR WITH STOPCOCK AND TEMPLATES. CARRIERS SHOULD NOT ALLOW SEPARATE PAYMENT FOR THIS CODE AND FOR A4212. REFILL KIT FOR IMPLANTABLE INFUSION PUMP
C1620968 A9064058 L5670693 S6502755 SCUI A4412 HPN 0124=PUBLICATION 100.2, CHAPTER 15, SS 120. OSTOMY POUCH, DRAINABLE, HIGH OUTPUT, FOR USE ON A BARRIER WITH FLANGE (2 PIECE SYSTEM), WITHOUT FILTER, EACH
C0993687 A2233055 L2046862 S2385401 SCUI A4714 HPN 0017=SEE INTERMEDIARY MANUAL SECTION 3170.5 FOR COVERAGE INSTRUCTIONS PERTAINING TO E1510-E1600, E1620, E1630-E1699, A4650-A4663, A4690, A4712, A4730-A4870, A4890-A4927. TREATED WATER (DEIONIZED, DISTILLED, OR REVERSE OSMOSIS) FOR PERITONEAL DIALYSIS, PER GALLON
C0993689 A2231599 L2045875 S2383803 SCUI A4720 HPN 0017=SEE INTERMEDIARY MANUAL SECTION 3170.5 FOR COVERAGE INSTRUCTIONS PERTAINING TO E1510-E1600, E1620, E1630-E1699, A4650-A4663, A4690, A4712, A4730-A4870, A4890-A4927. DIALYSATE SOLUTION, ANY CONCENTRATION OF DEXTROSE, FLUID VOLUME GREATER THAN 249CC, BUT LESS THAN OR EQUAL TO 999CC, FOR PERITONEAL DIALYSIS
C0993693 A2410752 L2341615 S2775347 SCUI A4724 HPN 0017=SEE INTERMEDIARY MANUAL SECTION 3170.5 FOR COVERAGE INSTRUCTIONS PERTAINING TO E1510-E1600, E1620, E1630-E1699, A4650-A4663, A4690, A4712, A4730-A4870, A4890-A4927. DIALYSATE SOLUTION, ANY CONCENTRATION OF DEXTROSE, FLUID VOLUME GREATER THAN 3999CC BUT LESS THAN OR EQUAL TO 4999CC, FOR PERITONEAL DIALYSIS
C0497910 A2231125 L2046422 S2383311 SCUI A4755 HPN 0017=SEE INTERMEDIARY MANUAL SECTION 3170.5 FOR COVERAGE INSTRUCTIONS PERTAINING TO E1510-E1600, E1620, E1630-E1699, A4650-A4663, A4690, A4712, A4730-A4870, A4890-A4927. BLOOD TUBING, ARTERIAL AND VENOUS COMBINED, FOR HEMODIALYSIS, EACH
C0993701 A2232876 L2045962 S2385209 SCUI A4771 HPN 0017=SEE INTERMEDIARY MANUAL SECTION 3170.5 FOR COVERAGE INSTRUCTIONS PERTAINING TO E1510-E1600, E1620, E1630-E1699, A4650-A4663, A4690, A4712, A4730-A4870, A4890-A4927. SERUM CLOTTING TIME TUBE, FOR DIALYSIS, PER 50
C0993702 A2231122 L2045960 S2383307 SCUI A4772 HPN 0017=SEE INTERMEDIARY MANUAL SECTION 3170.5 FOR COVERAGE INSTRUCTIONS PERTAINING TO E1510-E1600, E1620, E1630-E1699, A4650-A4663, A4690, A4712, A4730-A4870, A4890-A4927. BLOOD GLUCOSE TEST STRIPS, FOR DIALYSIS, PER 50
C0497922 A2231637 L2045719 S2383836 SCUI A4860 HPN 0017=SEE INTERMEDIARY MANUAL SECTION 3170.5 FOR COVERAGE INSTRUCTIONS PERTAINING TO E1510-E1600, E1620, E1630-E1699, A4650-A4663, A4690, A4712, A4730-A4870, A4890-A4927. DISPOSABLE CATHETER TIPS FOR PERITONEAL DIALYSIS, PER 10
C0993705 A2231643 L2046481 S2383841 SCUI A4911 HPN 0017=SEE INTERMEDIARY MANUAL SECTION 3170.5 FOR COVERAGE INSTRUCTIONS PERTAINING TO E1510-E1600, E1620, E1630-E1699, A4650-A4663, A4690, A4712, A4730-A4870, A4890-A4927. DRAIN BAG/BOTTLE, FOR DIALYSIS, EACH
C0497933 A2233147 L2046755 S2385507 SCUI A4918 HPN 0017=SEE INTERMEDIARY MANUAL SECTION 3170.5 FOR COVERAGE INSTRUCTIONS PERTAINING TO E1510-E1600, E1620, E1630-E1699, A4650-A4663, A4690, A4712, A4730-A4870, A4890-A4927. VENOUS PRESSURE CLAMP, FOR HEMODIALYSIS, EACH
C0500159 A9063233 L1218388 S1459992 SCUI A6538 HPN 0072=COMPRESSION LEVELS FOR PRODUCTS IDENTIFIED BY THESE CODES (L8100 - L8200) HAVE BEEN VALIDATED BY A ASTM/NAHM SANCTIONED INDEPENDENT TEST FACILITY. GRADIENT COMPRESSION STOCKING, FULL LENGTH/CHAP STYLE, 40-50 MMHG, EACH
C0500161 A9063237 L1218390 S1459994 SCUI A6541 HPN 0072=COMPRESSION LEVELS FOR PRODUCTS IDENTIFIED BY THESE CODES (L8100 - L8200) HAVE BEEN VALIDATED BY A ASTM/NAHM SANCTIONED INDEPENDENT TEST FACILITY. GRADIENT COMPRESSION STOCKING, WAIST LENGTH, 40-50 MMHG, EACH
C0993864 A2231315 L2046727 S2383505 SCUI E1500 HPN 0017=SEE INTERMEDIARY MANUAL SECTION 3170.5 FOR COVERAGE INSTRUCTIONS PERTAINING TO E1510-E1600, E1620, E1630-E1699, A4650-A4663, A4690, A4712, A4730-A4870, A4890-A4927. CENTRIFUGE, FOR DIALYSIS
C0498651 A2231879 L2047049 S2384098 SCUI E1520 HPN 0017=SEE INTERMEDIARY MANUAL SECTION 3170.5 FOR COVERAGE INSTRUCTIONS PERTAINING TO E1510-E1600, E1620, E1630-E1699, A4650-A4663, A4690, A4712, A4730-A4870, A4890-A4927. HEPARIN INFUSION PUMP FOR HEMODIALYSIS

HIR

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CUI METAUI LUI SUI STYPE CODE ATN ATV STR
C0497677 A0992772 L0699526 S0936870 SCUI QS HIR 15018I MONITORED ANESTHESIA CARE SERVICE
C0497787 A1061229 L0856238 S1003168 SCUI A4220 HIR 60-14 REFILL KIT FOR IMPLANTABLE INFUSION PUMP
C0497790 A0964087 L0770683 S0907113 SCUI A4230 HIR 60-14 INFUSION SET FOR EXTERNAL INSULIN PUMP, NON NEEDLE CANNULA TYPE
C0497805 A1036968 L0878089 S0978498 SCUI A4265 HIR 60-9 PARAFFIN, PER POUND
C0497858 A0949116 L0848503 S0890883 SCUI A4470 HIR 50-4 GRAVLEE JET WASHER
C0497862 A1077599 L0822944 S1020601 SCUI A4495 HIR 60-9 SURGICAL STOCKINGS THIGH LENGTH, EACH
C0497865 A9064564 L5671101 S6503762 SCUI A4554 HIR 60-9 DISPOSABLE UNDERPADS, ALL SIZES
C0497878 A0992857 L0872300 S0936979 SCUI A4617 HIR 60-4 MOUTH PIECE
C0500154 A9063219 L1218295 S1459884 SCUI A6533 HIR 60-9 GRADIENT COMPRESSION STOCKING, THIGH LENGTH, 18-30 MMHG, EACH
C0520218 A1752694 L0734963 S1801082 SCUI A7017 HIR 60-9 NEBULIZER, DURABLE, GLASS OR AUTOCLAVABLE PLASTIC, BOTTLE TYPE, NOT USED WITH OXYGEN
C0497983 A1008183 L0873473 S0951677 SCUI B4082 HIR 65-10 NASOGASTRIC TUBING WITHOUT STYLET
C0491127 A1077213 L0865908 S1020061 SCUI B4083 HIR 65-10 STOMACH TUBE - LEVINE TYPE
C0520086 A7185642 L5315943 S6058367 SCUI B4150 HIR 65-10 ENTERAL FORMULA, NUTRITIONALLY COMPLETE WITH INTACT NUTRIENTS, INCLUDES PROTEINS, FATS, CARBOHYDRATES, VITAMINS AND MINERALS, MAY INCLUDE FIBER, ADMINISTERED THROUGH AN ENTERAL FEEDING TUBE, 100 CALORIES = 1 UNIT
C0520088 A7185643 L5315935 S6058368 SCUI B4152 HIR 65-10 ENTERAL FORMULA, NUTRITIONALLY COMPLETE, CALORICALLY DENSE (EQUAL TO OR GREATER THAN 1.5 KCAL/ML) WITH INTACT NUTRIENTS, INCLUDES PROTEINS, FATS, CARBOHYDRATES, VITAMINS AND MINERALS, MAY INCLUDE FIBER, ADMINISTERED THROUGH AN ENTERAL FEEDING TUBE, 100 CALORIES = 1 UNIT
C1508844 A7185644 L5315941 S6058369 SCUI B4157 HIR 65-10 ENTERAL FORMULA, NUTRITIONALLY COMPLETE, FOR SPECIAL METABOLIC NEEDS FOR INHERITED DISEASE OF METABOLISM, INCLUDES PROTEINS, FATS, CARBOHYDRATES, VITAMINS AND MINERALS, MAY INCLUDE FIBER, ADMINISTERED THROUGH AN ENTERAL FEEDING TUBE, 100 CALORIES = 1 UNIT
C1508845 A7185639 L5315942 S6058364 SCUI B4158 HIR 65-10 ENTERAL FORMULA, FOR PEDIATRICS, NUTRITIONALLY COMPLETE WITH INTACT NUTRIENTS, INCLUDES PROTEINS, FATS, CARBOHYDRATES, VITAMINS AND MINERALS, MAY INCLUDE FIBER AND/OR IRON, ADMINISTERED THROUGH AN ENTERAL FEEDING TUBE, 100 CALORIES = 1 UNIT
C0497990 A1037026 L0619719 S0978567 SCUI B4178 HIR 65-10 PARENTERAL NUTRITION SOLUTION: AMINO ACID, GREATER THAN 8.5% (500 ML = 1 UNIT) - HOMEMIX
C0497991 A1037034 L0619852 S0978575 SCUI B4180 HIR 65-10 PARENTERAL NUTRITION SOLUTION; CARBOHYDRATES (DEXTROSE), GREATER THAN 50% (500 ML=1 UNIT) - HOMEMIX
C0497995 A1037038 L0644927 S0978579 SCUI B4193 HIR 65-10 PARENTERAL NUTRITION SOLUTION; COMPOUNDED AMINO ACID AND CARBOHYDRATES WITH ELECTROLYTES, TRACE ELEMENTS, AND VITAMINS, INCLUDING PREPARATION, ANY STRENGTH, 52 TO 73 GRAMS OF PROTEIN - PREMIX

HTD

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CUI METAUI LUI SUI STYPE CODE ATN ATV STR
C2368654 A16022223 L8200420 S10284313 SCUI C9237 HTD 20081231 INJECTION, LANREOTIDE ACETATE, 1 MG
C2368655 A16024093 L8200758 S10284333 SCUI C9244 HTD 20081231 INJECTION, REGADENOSON, 0.4 MG
C2368663 A16022229 L8200943 S10285524 SCUI C9357 HTD 20081231 DERMAL SUBSTITUTE, GRANULATED CROSS-LINKED COLLAGEN AND GLYCOSAMINOGLYCAN MATRIX (FLOWABLE WOUND MATRIX), 1 CC
C1508958 A16022496 L5316053 S6058331 SCUI G0317 HTD 20081231 END STAGE RENAL DISEASE (ESRD) RELATED SERVICES DURING THE COURSE OF TREATMENT, FOR PATIENTS 20 YEARS OF AGE AND OVER; WITH 4 OR MORE FACE-TO-FACE PHYSICIAN VISITS PER MONTH
C1508959 A16023268 L5316046 S6058330 SCUI G0318 HTD 20081231 END STAGE RENAL DISEASE (ESRD) RELATED SERVICES DURING THE COURSE OF TREATMENT, FOR PATIENTS 20 YEARS OF AGE AND OVER; WITH 2 OR 3 FACE-TO-FACE PHYSICIAN VISITS PER MONTH
C1508960 A16023536 L5315952 S6058329 SCUI G0319 HTD 20081231 END STAGE RENAL DISEASE (ESRD) RELATED SERVICES DURING THE COURSE OF TREATMENT, FOR PATIENTS 20 YEARS OF AGE AND OVER; WITH 1 FACE-TO-FACE PHYSICIAN VISIT PER MONTH
C1508961 A16022237 L5316268 S6058346 SCUI G0320 HTD 20081231 END STAGE RENAL DISEASE (ESRD) RELATED SERVICES FOR HOME DIALYSIS PATIENTS PER FULL MONTH; FOR PATIENTS UNDER TWO YEARS OF AGE TO INCLUDE MONITORING FOR ADEQUACY OF NUTRITION, ASSESSMENT OF GROWTH AND DEVELOPMENT, AND COUNSELING OF PARENTS
C1508963 A16022238 L5316267 S6058343 SCUI G0322 HTD 20081231 END STAGE RENAL DISEASE (ESRD) RELATED SERVICES FOR HOME DIALYSIS PATIENTS PER FULL MONTH; FOR PATIENTS TWELVE TO NINETEEN YEARS OF AGE TO INCLUDE MONITORING FOR ADEQUACY OF NUTRITION, ASSESSMENT OF GROWTH AND DEVELOPMENT, AND COUNSELING OF PARENTS
C1508964 A16024115 L5316311 S6058344 SCUI G0323 HTD 20081231 END STAGE RENAL DISEASE (ESRD) RELATED SERVICES FOR HOME DIALYSIS PATIENTS PER FULL MONTH; FOR PATIENTS TWENTY YEARS OF AGE AND OLDER
C0374169 A16022239 L0496469 S10285634 SCUI G0325 HTD 20081231 END STAGE RENAL DISEASE (ESRD) RELATED SERVICES LESS THAN FULL MONTH, PER DAY; FOR PATIENTS BETWEEN TWO AND ELEVEN YEARS OF AGE
C1508999 A16022497 L5670611 S6503842 SCUI G0366 HTD 20081231 ELECTROCARDIOGRAM, ROUTINE ECG WITH 12 LEADS; PERFORMED AS A COMPONENT OF THE INITIAL PREVENTIVE EXAMINATION WITH INTERPRETATION AND REPORT
C1617349 A16023036 L5670722 S6502264 SCUI J1752 HTD 20081231 INJECTION, IRON DEXTRAN 267, 50 MG
C1971354 A16023879 L6881775 S8013556 SCUI J7603 HTD 20081231 ALBUTEROL, ALL FORMULATIONS INCLUDING SEPARATED ISOMERS, INHALATION SOLUTION, FDA-APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE, PER 1 MG (ALBUTEROL) OR PER 0.5 MG (LEVALBUTEROL)
C1145286 A16023310 L6139630 S7050447 SCUI L5995 HTD 20081231 ADDITION TO LOWER EXTREMITY PROSTHESIS, HEAVY DUTY FEATURE, OTHER THAN FOOT OR KNEE, (FOR PATIENT WEIGHT GREATER THAN 300 LBS)
C1971366 A16022543 L6881732 S8013090 SCUI L7613 HTD 20081231 TERMINAL DEVICE, HAND, MECHANICAL, VOLUNTARY OPENING, ANY MATERIAL, ANY SIZE, PEDIATRIC
C0812737 A16023317 L1506046 S1800164 SCUI Q4098 HTD 20081231 INJECTION, IRON DEXTRAN, 50 MG
C2368488 A16023897 L8201055 S10284079 SCUI Q4099 HTD 20081231 FORMOTEROL FUMARATE, INHALATION SOLUTION, FDA APPROVED FINAL PRODUCT, NON-COMPOUNDED, ADMINISTERED THROUGH DME, UNIT DOSE FORM, 20 MICROGRAMS
C1616350 A16023324 L5671635 S6502417 SCUI S2075 HTD 20081231 LAPAROSCOPY, SURGICAL; REPAIR INCISIONAL OR VENTRAL HERNIA
C1145337 A16023064 L2342226 S2775106 SCUI S9092 HTD 20081231 CANOLITH REPOSITIONING, PER VISIT

HPD

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CUI METAUI LUI SUI STYPE CODE ATN ATV STR
C1145135 A7184966 L5316312 S6057262 SCUI G0260 HPD 20030101 INJECTION PROCEDURE FOR SACROILIAC JOINT; PROVISION OF ANESTHETIC, STEROID AND/OR OTHER THERAPEUTIC AGENT, WITH OR WITHOUT ARTHROGRAPHY
C0993727 A13298017 L6881583 S8013260 SCUI C1716 HPD 20080101 BRACHYTHERAPY SOURCE, NON-STRANDED, GOLD-198, PER SOURCE
C0993728 A13296665 L6881408 S8013263 SCUI C1717 HPD 20080101 BRACHYTHERAPY SOURCE, NON-STRANDED, HIGH DOSE RATE IRIDIUM-192, PER SOURCE
C1616805 A13297352 L6882450 S8013258 SCUI C2636 HPD 20080101 BRACHYTHERAPY LINEAR SOURCE, NON-STRANDED, PALADIUM-103, PER 1 MM
C1971553 A13295918 L6881918 S8013259 SCUI C2643 HPD 20080101 BRACHYTHERAPY SOURCE, NON-STRANDED, CESIUM-131, PER SOURCE
C0993819 A2232374 L2046034 S2384623 SCUI C8900 HPD 20080101 MAGNETIC RESONANCE ANGIOGRAPHY WITH CONTRAST, ABDOMEN
C0993821 A2232377 L2046033 S2384626 SCUI C8902 HPD 20080101 MAGNETIC RESONANCE ANGIOGRAPHY WITHOUT CONTRAST FOLLOWED BY WITH CONTRAST, ABDOMEN
C1314281 A3861755 L3155483 S3677724 SCUI C8918 HPD 20080101 MAGNETIC RESONANCE ANGIOGRAPHY WITH CONTRAST, PELVIS
C1314282 A3861757 L3155484 S3677726 SCUI C8919 HPD 20080101 MAGNETIC RESONANCE ANGIOGRAPHY WITHOUT CONTRAST, PELVIS
C1617317 A9064623 L5671397 S6503866 SCUI C9724 HPD 20080101 ENDOSCOPIC FULL-THICKNESS PLICATION IN THE GASTRIC CARDIA USING ENDOSCOPIC PLICATION SYSTEM (EPS); INCLUDES ENDOSCOPY
C1736933 A11002245 L6139679 S7049723 SCUI C9727 HPD 20080101 INSERTION OF IMPLANTS INTO THE SOFT PALATE; MINIMUM OF THREE IMPLANTS
C0919000 A7185056 L5316205 S6057409 SCUI G0173 HPD 20080101 LINEAR ACCELERATOR BASED STEREOTACTIC RADIOSURGERY, COMPLETE COURSE OF THERAPY IN ONE SESSION
C1145126 A2411411 L2341779 S2775969 SCUI G0251 HPD 20080101 LINEAR ACCELERATOR BASED STEREOTACTIC RADIOSURGERY, DELIVERY INCLUDING COLLIMATOR CHANGES AND CUSTOM PLUGGING, FRACTIONATED TREATMENT, ALL LESIONS, PER SESSION, MAXIMUM FIVE SESSIONS PER COURSE OF TREATMENT
C1314411 A7184971 L5316110 S6057267 SCUI J0152 HPD 20080101 INJECTION, ADENOSINE FOR DIAGNOSTIC USE, 30 MG (NOT TO BE USED TO REPORT ANY ADENOSINE PHOSPHATE COMPOUNDS; INSTEAD USE A9270)
C0694954 A1413159 L1218417 S1460029 SCUI J0476 HPD 20080101 INJECTION, BACLOFEN, 50 MCG FOR INTRATHECAL TRIAL
C1741403 A11002466 L6139587 S7049693 SCUI J0594 HPD 20080101 INJECTION, BUSULFAN, 1 MG
C1617348 A9063715 L5670526 S6502245 SCUI J0881 HPD 20080101 INJECTION, DARBEPOETIN ALFA, 1 MICROGRAM (NON-ESRD USE)
C1616330 A9063717 L5670588 S6502247 SCUI J0885 HPD 20080101 INJECTION, EPOETIN ALFA, (FOR NON-ESRD USE), 1000 UNITS
C1738018 A11003614 L6139972 S7049694 SCUI J0894 HPD 20080101 INJECTION, DECITABINE, 1 MG

HPG

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CUI METAUI LUI SUI STYPE CODE ATN ATV STR
C0520135 A0887931 L0770479 S0829415 SCUI G0121 HPG YY COLORECTAL CANCER SCREENING; COLONOSCOPY ON INDIVIDUAL NOT MEETING CRITERIA FOR HIGH RISK
C0993728 A13296665 L6881408 S8013263 SCUI C1717 HPG YY BRACHYTHERAPY SOURCE, NON-STRANDED, HIGH DOSE RATE IRIDIUM-192, PER SOURCE
C0993730 A13297335 L6881919 S8013265 SCUI C1719 HPG YY BRACHYTHERAPY SOURCE, NON-STRANDED, NON-HIGH DOSE RATE IRIDIUM-192, PER SOURCE
C0993805 A13299446 L6881220 S8013269 SCUI C2616 HPG YY BRACHYTHERAPY SOURCE, NON-STRANDED, YTTRIUM-90, PER SOURCE
C1616805 A13297352 L6882450 S8013258 SCUI C2636 HPG YY BRACHYTHERAPY LINEAR SOURCE, NON-STRANDED, PALADIUM-103, PER 1 MM
C1971549 A13300145 L6881409 S8013264 SCUI C2639 HPG YY BRACHYTHERAPY SOURCE, NON-STRANDED, IODINE-125, PER SOURCE
C1971551 A13298028 L6881584 S8013267 SCUI C2641 HPG YY BRACHYTHERAPY SOURCE, NON-STRANDED, PALLADIUM-103, PER SOURCE
C1971555 A13295919 L6882451 S8013266 SCUI C2699 HPG YY BRACHYTHERAPY SOURCE, NON-STRANDED, NOT OTHERWISE SPECIFIED, PER SOURCE
C0993820 A2232380 L2046035 S2384629 SCUI C8901 HPG YY MAGNETIC RESONANCE ANGIOGRAPHY WITHOUT CONTRAST, ABDOMEN
C0993824 A2232388 L2046601 S2384637 SCUI C8905 HPG YY MAGNETIC RESONANCE IMAGING WITHOUT CONTRAST FOLLOWED BY WITH CONTRAST, BREAST; UNILATERAL
C1617317 A9064623 L5671397 S6503866 SCUI C9724 HPG YY ENDOSCOPIC FULL-THICKNESS PLICATION IN THE GASTRIC CARDIA USING ENDOSCOPIC PLICATION SYSTEM (EPS); INCLUDES ENDOSCOPY
C0520123 A0887933 L0770481 S0829417 SCUI G0104 HPG YY COLORECTAL CANCER SCREENING; FLEXIBLE SIGMOIDOSCOPY
C0694936 A1413592 L1218863 S1460528 SCUI G0127 HPG YY TRIMMING OF DYSTROPHIC NAILS, ANY NUMBER
C1145126 A2411411 L2341779 S2775969 SCUI G0251 HPG YY LINEAR ACCELERATOR BASED STEREOTACTIC RADIOSURGERY, DELIVERY INCLUDING COLLIMATOR CHANGES AND CUSTOM PLUGGING, FRACTIONATED TREATMENT, ALL LESIONS, PER SESSION, MAXIMUM FIVE SESSIONS PER COURSE OF TREATMENT
C1314411 A7184971 L5316110 S6057267 SCUI J0152 HPG YY INJECTION, ADENOSINE FOR DIAGNOSTIC USE, 30 MG (NOT TO BE USED TO REPORT ANY ADENOSINE PHOSPHATE COMPOUNDS; INSTEAD USE A9270)
C1321603 A0964204 L0644316 S0907271 SCUI J0207 HPG YY INJECTION, AMIFOSTINE, 500 MG
C0498752 A0964399 L0635079 S0907483 SCUI J0210 HPG YY INJECTION, METHYLDOPATE HCL, UP TO 250 MG
C1145187 A2411203 L2341462 S2775774 SCUI J0288 HPG YY INJECTION, AMPHOTERICIN B CHOLESTERYL SULFATE COMPLEX, 10 MG
C0694954 A1413159 L1218417 S1460029 SCUI J0476 HPG YY INJECTION, BACLOFEN, 50 MCG FOR INTRATHECAL TRIAL

HSN

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CUI METAUI LUI SUI STYPE CODE ATN ATV STR
C0493327 A1413827 L1219078 S1460787 SCUI A4261 HSN 1862a1 CERVICAL CAP FOR CONTRACEPTIVE USE
C1617310 A9064173 L5671188 S6503076 SCUI A9281 HSN 1862 SSA REACHING/GRABBING DEVICE, ANY TYPE, ANY LENGTH, EACH
C0993725 A7184688 L2046460 S2383491 SCUI C1714 HSN 1833(T) CATHETER, TRANSLUMINAL ATHERECTOMY, DIRECTIONAL
C0993738 A7184666 L2046492 S2383437 SCUI C1727 HSN 1833(T) CATHETER, BALLOON TISSUE DISSECTOR, NON-VASCULAR (INSERTABLE)
C0993739 A7184667 L2046167 S2383440 SCUI C1728 HSN 1833(T) CATHETER, BRACHYTHERAPY SEED ADMINISTRATION
C0993740 A7184669 L2045822 S2383452 SCUI C1730 HSN 1833(T) CATHETER, ELECTROPHYSIOLOGY, DIAGNOSTIC, OTHER THAN 3D MAPPING (19 OR FEWER ELECTRODES)
C0993741 A7184670 L2045851 S2383453 SCUI C1731 HSN 1833(T) CATHETER, ELECTROPHYSIOLOGY, DIAGNOSTIC, OTHER THAN 3D MAPPING (20 OR MORE ELECTRODES)
C0993746 A11002620 L6139828 S7050763 SCUI C1752 HSN 1833(T) CATHETER, HEMODIALYSIS/PERITONEAL, SHORT-TERM
C0993748 A7184679 L2046722 S2383467 SCUI C1754 HSN 1833(T) CATHETER, INTRADISCAL
C0993750 A7184685 L2046719 S2383487 SCUI C1757 HSN 1833(T) CATHETER, THROMBECTOMY/EMBOLECTOMY
C0993751 A7184678 L2046718 S2383466 SCUI C1759 HSN 1833(T) CATHETER, INTRACARDIAC ECHOCARDIOGRAPHY
C0993756 A2230940 L2046129 S2383113 SCUI C1765 HSN 1833(T) ADHESION BARRIER
C0993757 A7184717 L2046475 S2384491 SCUI C1766 HSN 1833(T) INTRODUCER/SHEATH, GUIDING, INTRACARDIAC ELECTROPHYSIOLOGICAL, STEERABLE, OTHER THAN PEEL-AWAY
C1964018 A7184704 L0222241 S2384023 SCUI C1768 HSN 1833(T) GRAFT, VASCULAR
C0993760 A7184750 L2046883 S2385067 SCUI C1771 HSN 1833(T) REPAIR DEVICE, URINARY, INCONTINENCE, WITH SLING GRAFT
C0993764 A7184722 L2046637 S2384563 SCUI C1777 HSN 1833(T) LEAD, CARDIOVERTER-DEFIBRILLATOR, ENDOCARDIAL SINGLE COIL (IMPLANTABLE)
C0993767 A7184729 L2047126 S2384579 SCUI C1780 HSN 1833(T) LENS, INTRAOCULAR (NEW TECHNOLOGY)
C0993770 A7184738 L2046732 S2384820 SCUI C1785 HSN 1833(T) PACEMAKER, DUAL CHAMBER, RATE-RESPONSIVE (IMPLANTABLE)
C0993774 A7184744 L2046606 S2384957 SCUI C1789 HSN 1833(T) PROSTHESIS, BREAST (IMPLANTABLE)

HXR

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CUI METAUI LUI SUI STYPE CODE ATN ATV STR
C0497594 A1038485 L0870405 S0980394 SCUI AM HXR QM PHYSICIAN, TEAM MEMBER SERVICE
C0497707 A0848901 L0694459 S0789356 SCUI A0021 HXR A0030 AMBULANCE SERVICE, OUTSIDE STATE PER MILE, TRANSPORT (MEDICAID ONLY)
C0497757 A0874133 L0748068 S0814491 SCUI A0380 HXR A0425 BLS MILEAGE (PER MILE)
C0497760 A0848786 L0691357 S0789219 SCUI A0390 HXR A0425 ALS MILEAGE (PER MILE)
C0498478 A1075457 L0653687 S1017880 SCUI E0627 HXR Q0080 SEAT LIFT MECHANISM INCORPORATED INTO A COMBINATION LIFT-CHAIR MECHANISM
C0498479 A1075562 L0824677 S1018007 SCUI E0628 HXR Q0078 SEPARATE SEAT LIFT MECHANISM FOR USE WITH PATIENT OWNED FURNITURE-ELECTRIC
C0498480 A1075563 L0824676 S1018008 SCUI E0629 HXR Q0079 SEPARATE SEAT LIFT MECHANISM FOR USE WITH PATIENT OWNED FURNITURE-NON-ELECTRIC
C0498550 A1008627 L0632456 S0952224 SCUI E0970 HXR K0037 NO.2 FOOTPLATES, EXCEPT FOR ELEVATING LEG REST
C0498550 A1008627 L0632456 S0952224 SCUI E0970 HXR K0042 NO.2 FOOTPLATES, EXCEPT FOR ELEVATING LEG REST
C0492053 A9063873 L5670968 S6502523 SCUI E0971 HXR K0021 MANUAL WHEELCHAIR ACCESSORY, ANTI-TIPPING DEVICE, EACH
C0498580 A0954084 L0719801 S0895968 SCUI E1086 HXR K0002 HEMI-WHEELCHAIR DETACHABLE ARMS DESK OR FULL LENGTH, SWING AWAY DETACHABLE FOOTRESTS
C0498583 A0954512 L0719817 S0896670 SCUI E1089 HXR K0004 HIGH STRENGTH LIGHTWEIGHT WHEELCHAIR, FIXED LENGTH ARMS, SWING AWAY DETACHABLE FOOTREST
C0498584 A0954510 L0719798 S0896668 SCUI E1090 HXR K0004 HIGH STRENGTH LIGHTWEIGHT WHEELCHAIR, DETACHABLE ARMS DESK OR FULL LENGTH, SWING AWAY DETACHABLE FOOT RESTS
C0498590 A1077033 L0719813 S1019865 SCUI E1130 HXR K0001 STANDARD WHEELCHAIR, FIXED FULL LENGTH ARMS, FIXED OR SWING AWAY DETACHABLE FOOTRESTS
C0498591 A1119018 L0719803 S1061192 SCUI E1140 HXR K0001 WHEELCHAIR, DETACHABLE ARMS, DESK OR FULL LENGTH, SWING AWAY DETACHABLE FOOTRESTS
C0498616 A0981706 L0719816 S0925059 SCUI E1250 HXR K0003 LIGHTWEIGHT WHEELCHAIR, FIXED FULL LENGTH ARMS, SWING AWAY DETACHABLE FOOTREST
C0498617 A0981703 L0719802 S0925056 SCUI E1260 HXR K0003 LIGHTWEIGHT WHEELCHAIR, DETACHABLE ARMS (DESK OR FULL LENGTH) SWING AWAY DETACHABLE FOOTREST
C0498620 A0954006 L0719805 S0895861 SCUI E1285 HXR K0006 HEAVY DUTY WHEELCHAIR, FIXED FULL LENGTH ARMS, SWING AWAY DETACHABLE FOOTREST
C0498621 A0954003 L0719792 S0895858 SCUI E1290 HXR K0006 HEAVY DUTY WHEELCHAIR, DETACHABLE ARMS (DESK OR FULL LENGTH) SWING AWAY DETACHABLE FOOTREST

HLC

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CUI METAUI LUI SUI STYPE CODE ATN ATV STR
C0498693 A3860551 L0697976 S1017968 SCUI G0027 HLC 400=Hematology SEMEN ANALYSIS; PRESENCE AND/OR MOTILITY OF SPERM EXCLUDING HUHNER
C0812710 A11002460 L6139904 S7050251 SCUI G0103 HLC 310=Routine chemistry PROSTATE CANCER SCREENING; PROSTATE SPECIFIC ANTIGEN TEST (PSA)
C0694932 A1413578 L1218852 S1460516 SCUI G0123 HLC 630=Cytology SCREENING CYTOPATHOLOGY, CERVICAL OR VAGINAL (ANY REPORTING SYSTEM), COLLECTED IN PRESERVATIVE FLUID, AUTOMATED THIN LAYER PREPARATION, SCREENING BY CYTOTECHNOLOGIST UNDER PHYSICIAN SUPERVISION
C0694933 A1413579 L1218853 S1460517 SCUI G0124 HLC 630=Cytology SCREENING CYTOPATHOLOGY, CERVICAL OR VAGINAL (ANY REPORTING SYSTEM), COLLECTED IN PRESERVATIVE FLUID, AUTOMATED THIN LAYER PREPARATION, REQUIRING INTERPRETATION BY PHYSICIAN
C0694942 A1413705 L1218967 S1460647 SCUI G0141 HLC 630=Cytology SCREENING CYTOPATHOLOGY SMEARS, CERVICAL OR VAGINAL, PERFORMED BY AUTOMATED SYSTEM, WITH MANUAL RESCREENING, REQUIRING INTERPRETATION BY PHYSICIAN
C0694943 A1413577 L1218851 S1460515 SCUI G0143 HLC 630=Cytology SCREENING CYTOPATHOLOGY, CERVICAL OR VAGINAL (ANY REPORTING SYSTEM), COLLECTED IN PRESERVATIVE FLUID, AUTOMATED THIN LAYER PREPARATION, WITH MANUAL SCREENING AND RESCREENING BY CYTOTECHNOLOGIST UNDER PHYSICIAN SUPERVISION
C0694944 A2412197 L2342004 S2776680 SCUI G0144 HLC 630=Cytology SCREENING CYTOPATHOLOGY, CERVICAL OR VAGINAL (ANY REPORTING SYSTEM), COLLECTED IN PRESERVATIVE FLUID, AUTOMATED THIN LAYER PREPARATION, WITH SCREENING BY AUTOMATED SYSTEM, UNDER PHYSICIAN SUPERVISION
C0694945 A2412196 L2342003 S2776679 SCUI G0145 HLC 630=Cytology SCREENING CYTOPATHOLOGY, CERVICAL OR VAGINAL (ANY REPORTING SYSTEM), COLLECTED IN PRESERVATIVE FLUID, AUTOMATED THIN LAYER PREPARATION, WITH SCREENING BY AUTOMATED SYSTEM AND MANUAL RESCREENING UNDER PHYSICIAN SUPERVISION
C0694946 A1413707 L1218970 S1460650 SCUI G0147 HLC 630=Cytology SCREENING CYTOPATHOLOGY SMEARS, CERVICAL OR VAGINAL, PERFORMED BY AUTOMATED SYSTEM UNDER PHYSICIAN SUPERVISION
C0694947 A1413706 L1218968 S1460648 SCUI G0148 HLC 630=Cytology SCREENING CYTOPATHOLOGY SMEARS, CERVICAL OR VAGINAL, PERFORMED BY AUTOMATED SYSTEM WITH MANUAL RESCREENING
C1314380 A3862553 L3155531 S3678496 SCUI G0306 HLC 400=Hematology COMPLETE CBC, AUTOMATED (HGB, HCT, RBC, WBC, WITHOUT PLATELET COUNT) AND AUTOMATED WBC DIFFERENTIAL COUNT
C1314381 A3862550 L3155533 S3678493 SCUI G0307 HLC 400=Hematology COMPLETE (CBC), AUTOMATED (HGB, HCT, RBC, WBC; WITHOUT PLATELET COUNT)
C1508969 A7185467 L5315955 S6058117 SCUI G0328 HLC 310=Routine chemistry COLORECTAL CANCER SCREENING; FECAL OCCULT BLOOD TEST, IMMUNOASSAY, 1-3 SIMULTANEOUS
C1508969 A7185467 L5315955 S6058117 SCUI G0328 HLC 400=Hematology COLORECTAL CANCER SCREENING; FECAL OCCULT BLOOD TEST, IMMUNOASSAY, 1-3 SIMULTANEOUS
C0500235 A1075367 L0779309 S1017790 SCUI P3000 HLC 630=Cytology SCREENING PAPANICOLAOU SMEAR, CERVICAL OR VAGINAL, UP TO THREE SMEARS, BY TECHNICIAN UNDER PHYSICIAN SUPERVISION
C0500236 A1075368 L0779071 S1017791 SCUI P3001 HLC 630=Cytology SCREENING PAPANICOLAOU SMEAR, CERVICAL OR VAGINAL, UP TO THREE SMEARS, REQUIRING INTERPRETATION BY PHYSICIAN
C0500237 A0889227 L0738350 S0831041 SCUI P7001 HLC 110=Bacteriology CULTURE, BACTERIAL, URINE; QUANTITATIVE, SENSITIVITY STUDY
C0500271 A1118996 L0779051 S1061152 SCUI Q0111 HLC 110=Bacteriology WET MOUNTS, INCLUDING PREPARATIONS OF VAGINAL, CERVICAL OR SKIN SPECIMENS
C0500271 A1118996 L0779051 S1061152 SCUI Q0111 HLC 120=Mycology WET MOUNTS, INCLUDING PREPARATIONS OF VAGINAL, CERVICAL OR SKIN SPECIMENS