Abatacept (Orencia®)

Abdominoplasty and/or Panniculectomy

Acupuncture

Add-on Codes

Adult Sleep Disorder Testing

Agalsidase beta (Fabrazyme®)

Airway-Clearance Devices for Use in the Home Setting

Alglucerase (Ceredase®) and Imiglucerase (Cerezyme®)

Alglucosidase alfa, rhGAA (Myozyme®)

Allergy Immunotherapy

Alternative Therapies and Complementary Medicine

Ambulatory Blood Pressure Monitoring (ABPM)

Ambulatory, Real-Time Cardiac Surveillance System

Anesthesia Services for a Cancelled or Discontinued Procedure

Ankle-Foot/Knee-Ankle-Foot Orthoses

Antiprothrombin (phospholipid cofactor) Antibody Testing

Apheresis Therapy

Application and Removal of Tattoos

Arthroscopic Electrothermal Joint Repair

Artificial Intervertebral Disc Insertion

Assays of Genetic Expression in Tumor Tissue for Breast Cancer Prognosis

Auditory Brainstem Implant

Autologous Blood Services (Collection, Storage, Transfusion, and Perioperative Salvage)

Autologous Chondrocyte Transplantation (ACT)/Carticel®

Autologous Platelet-Derived Growth Factors as a Treatment for Wound Healing and Other Miscellaneous Conditions

Automatic External and Wearable Cardioverter Defibrillators

Balloon Sinuplasty for the Treatment of Chronic Sinusitis

Bariatric Surgery

Bevacizumab (Avastin®)

Biofeedback Therapy

Blepharoplasty with or without Repair of Blepharoptosis and/or Repair of Brow Ptosis

Blood Pressure Devices for Home Use

Bone Growth Stimulators

Bone Mineral Density (BMD) Testing

Bortezomib (Velcade®)

Botulinum Toxin Type A and Type B

Brachytherapy

Breast Ductal Lavage, Suction Collection of Nipple Aspirate Fluid, and Breast Duct Endoscopy

Bulking Agents for the Treatment of Stress Urinary Incontinence (SUI) due to Intrinsic Sphincter Deficiency (ISD) and for the Treatment of Vesicoureteral Reflux (VUR)

Cardiac Event Detection Monitoring (External Loop Monitoring)

Cardiac Rehabilitation

Cast and Splint Applications and Associated Supplies Provided in the Office Setting

Catheter Ablation of Cardiac Arrhythmias

Cervical Traction for In-home Use

Cetuximab (Erbitux®)

Chemical Peels

Chiropractic Spinal and Extraspinal Manipulation Therapy

Ciliary Body Destruction; Endoscopic Cyclophotocoagulation (ECP)

Circumcision

Clitoral Therapy Devices (CDT)

Cochlear Implant

Cold Laser Therapy

Collection and Interpretation of Physiologic Data

Colorectal Cancer Screening

Complex Regional Pain Syndrome (CRPS) Parenteral Treatments

Compression Garments

Computer-Assisted Musculoskeletal Surgical Navigational Orthopedic Procedure

Computer Aided Detection (CAD) System for use with Chest Radiographs

Computer Analysis and Generation of Automated Data in Conjunction with Diagnostic Studies

Continuous Local Delivery of Anesthesia to Operative Sites Using an Elastomeric Infusion Pump

Continuous Passive Motion (CPM) Devices in the Home Setting

Corneal Liquid Bandage Lens for the Treatment of Persistent (Corneal) Epithelial Defects

Corneal Pachymetry Using Ultrasound

Cranial Remolding Orthoses (Helmets)

Cryosurgical Ablation of Breast Tumors

Cryosurgical Ablation of the Prostate Gland

Day Rehabilitation

Debridement of Mycotic and Symptomatic Non-Mycotic Hypertrophic Nails

Decongestive Lymphedema Therapy (DLT)

Deep Brain Stimulation

Dental Extractions Prior to Cardiac Surgery, Radiation Therapy, or Transplant Surgery

Diagnosis Criteria for Reimbursement of Emergency Room Services

Diagnostic and Therapeutic Radiopharmaceutical Agents

Diagnostic Radiology Services Included in Capitation

Direct Access Obstetrics/Gynecology (OB/GYN)

Direct Measurement of Intermediate-Density Lipoproteins

Dofetilide (Tikosyn®) Use in the Inpatient Setting

Dual-Energy X-ray Absorptiometry (DEXA) Body Composition Study

Durable Medical Equipment (DME) Not Subject to a Rental to Purchase Maximum

Durable Medical Equipment (DME)

Echocardiography Contrast Agents

Elective Abortion

Electrical Stimulation and Electromagnetic Stimulation for the Treatment of Wounds

Electrocardiogram (ECG/EKG) Reported with Single Photon Emission Computed Tomography (SPECT) for Myocardial Perfusion Imaging (MPI)

Electromyography (EMG) (Needle and non-Needle) of the Anal or Urethral Sphincter

Electron Beam Computed Tomography (EBCT) for Screening Evaluations

Electronic Speech Aids

Electrosleep Therapy using a Cranial Electrical Stimulation Device

End-Diastolic Pneumatic Compression Therapy

Endometrial Ablation

Endovascular Grafts for Abdominal Aortic Aneurysms (AAA), Aortic-Iliac Aneurysms, and Infrarenal Aortic Aneurysms

Endovascular Stent-Graft Repair of Thoracic Aortic Aneurysm

Epoprostenol (Flolan®) and Treprostinil (Remodulin®)

Equipment, Supplies, and Pharmaceuticals for the Treatment of Diabetes

Erythropoiesis Stimulating Agents (ESAs)

Evaluation and Management of Autism Spectrum Disorders (ASD)

Evaluation and Management (E&M) of Diabetic Peripheral Neuropathy with Loss of Protective Sensation (LOPS)

Evaluation and Treatment of Erectile Dysfunction

Evaluation or Setup of a Cardiac Pacemaker Reported with an Electrocardiogram (ECG/EKG)

Excision of Redundant Skin

Experimental/Investigational Services

External Breast Prostheses, Mastectomy Bras, and Post-Mastectomy Camisoles

External Counterpulsation (ECP)

Extracorporeal Photopheresis

Extracorporeal Shock Wave Therapy (ESWT) for Musculoskeletal Conditions

Extraction of Bony Impacted Teeth and Exposure of Impacted Teeth

Fetal Fibronectin Enzyme Immunoassay

Fetal Surgery

First-Trimester Prenatal Screening for Fetal Aneuploidy

Food and Drug Administration (FDA) Approval of Medical Devices

Foot Orthotics and Other Podiatric Appliances

Full-Body Computerized Tomography (CT) Scan Screening

Full-Body Monoplace or Multiplace Chamber Hyperbaric Oxygen Therapy

Gastric Electrical Stimulation (Enterra™), Gastric Pacing

Genetic Testing for Congenital Long QT Syndrome

Genetic Testing for Inherited Breast Cancer 1 (BRCA1) and Breast Cancer 2 (BRCA2) Mutations

Guidelines for Well Mother/Well Baby Visits Under the Mother's Option Program

Hair Transplants and Cranial Prostheses (Wigs)

Hearing Aid Devices, Testing, Fittings, and Accessories

Hematopoietic Stem Cell Transplantation (Bone Marrow Transplant)

High-Frequency Chest Wall Oscillation Devices

High-Technology Diagnostic Radiology Services

High Osmolar Contrast Agents

Hippotherapy/Equestrian Therapy

Home-use Light Box for the Treatment of Seasonal Affective Disorder (SAD)

Home Health Care Services

Home Oxygen Therapy

Home Use of Interferential and Sequential Stimulation Devices

Home Uterine Activity Monitoring (HUAM) Devices

Home Visits by a Physician

Hospice and Respite Care

Hospital Beds and Accessories

Human Immunodeficiency Virus (HIV) Genotyping and Phenotyping

Human Papillomavirus (HPV) Vaccine(s)

Humanitarian Use Devices (HUD) and the Humanitarian Device Exemption (HDE) Process

Hyperthermic Intraperitoneal Chemotherapy (HIPEC)

Ibandronate Sodium (Boniva®) for Intravenous Injection

Idursulfase (Elaprase™)

Immune Globulin: Intravenous (IVIG), Subcutaneous (SCIG)

Immune Prophylaxis for Respiratory Syncytial Virus (RSV)

Implantable Cardiac Loop Monitor

Implantation of Intrastromal Corneal Ring Segments (INTACS)

In Vitro Allergy Testing

In Vitro Chemosensitivity and Chemoresistance Assays

In Vivo Allergy Sensitivity Testing

Infliximab (Remicade®)

Infusion Therapy Services as Performed by Home Infusion Providers

Inpatient Administration of Dihydroergotamine Mesylate (D.H.E. 45®) Injection

Insertion of Implantable Infusion Pumps

Insertion or Application of Urinary Catheters and the Associated Supplies Provided in the Office Setting

Intensity Modulated Radiation Therapy (IMRT)

Interstitial Continuous Glucose Monitoring Systems (CGMS)

Intestinal Rehabilitation Program

Intra-articular Injection of Hyaluronan for the Treatment of Osteoarthritis

Intracoronary Brachytherapy

Intraoperative Neurophysiological Monitoring (INM)

Intravenous Chelation Therapy

Intravenous (IV) Administration of Fluids as a Treatment of a Medical Condition or for the Preparation of Pharmaceuticals, Biologics, and other Substances

Islet Cell Transplantation

Ketogenic Diet for Children as a Treatment for Refractory Epilepsy

Knee Braces

Kyphoplasty

Laronidase (Aldurazyme®)

Lipectomy and/or Liposuction

Low Osmolar Contrast Agents

Lower Limb Prostheses

Lumbar Interspinous Process Decompression

Lung Volume Reduction Surgery

Lyme Disease: Diagnosis and Intravenous (IV) Antibiotic Treatment

Lysis of Epidural Adhesions

Magnetic Resonance Angiography (MRA) of the Spine

Magnetic Resonance Imaging (MRI) Contrast Agents

Magnetic Resonance Spectroscopy (MRS)

Magnetoencephalography (MEG) with Magnetic Source Imaging (MSI) (PCT)

Mammography and Computer-Aided Detection (CAD) System for Mammography

Manual Wheelchairs

Maze Procedure(s)

Measurement of Exhaled Nitric Oxide and Breath Condensate in the Diagnosis and Management of Asthma and Other Respiratory Disorders

Medical Evaluation and Management for Attention-Deficit Hyperactivity Disorder (ADHD)

Medical Foods, Low-Protein Modified Food Products, Nutritional Formulas, and Enteral Nutrition

Medicare Part B vs. Part D Crossover Drugs

Meniscal Allograft Transplantation

Mentoplasty or Genioplasty

Metal-on-Metal Total Hip Resurfacing

Microprocessor-Controlled Prosthetic Knees

Microwave Thermotherapy for Primary Breast Cancer

Minimally Invasive Treatments for Urinary Outlet Obstruction due to Benign Prostatic Hyperplasia (BPH)

MMR Genetic Testing for Colorectal Cancer

Modifier 24: Unrelated Evaluation and Management Service by the Same Physician during a Postoperative Period

Modifier 25: Significant, Separately Identifiable Evaluation and Management Service by the Same Physician on the Same Day of the Procedure or Other Service

Modifier 50: Bilateral Procedure

Modifier 51 Exempt

Modifier 51: Multiple Procedures

Modifier 57: Decision for Surgery

Modifier 59: Distinct Procedural Service

Modifier 62: Two Surgeons

Modifier 66: Surgical Team

Modifier 76: Repeat Procedure by Same Physician

Modifier 77: Repeat Procedure by Another Physician

Modifier 78: Unplanned Return to the Operating/Procedure Room by the Same Physician Following the Initial Procedure for a Related Procedure During the Postoperative Period