Coding Jobaid 2016

SUTURE
REMOVAL
L1523
8/24/15
Allergys
pencilline
antibiotics
sulfonamid
anti infactin
anesthetics
Narcotics
long term drug

V14.0 Z88.0
V14.1 Z88.1
V14.2 Z88.2
V14.3
V14.4
V14.5
anti coagulant
antibiotic
antiplatletes
NSAID
steroids
V58.61 Z79.01
V58.62 Z79.2
V58.63
V58.64
V58.65
female pain
tooth
Vbleed
eye pain
eye prob
Analgesics V14.6 Z88.6

serum/Vacci V14.7
aspirin
insulin
V58.66 Z79.82
V58.67
Dent pain 525.9

Dent absce 522.5
other medica V14.8 Z88.8
bisphosphonate V58.68
unspes med V14.9
other
Abn EKG
V58.69 Z79.899 RBBB

V68.1
625.9
525.9
623.8
379.91
372.0x
794.31
426.4
peanut
V15.01 Z91.010 Rx refill
milk
V15.02 Z91.011 WOUNDCHEK V58.30
egg
V15.03 Z91.012 sutur remoVal
seafood
V15.04 Z91.013
51702
foley
othr food
V15.05 Z91.018
36415
Blood draw/vinapancture
insect
V15.06 Z91.038
64400
DENTAL BLOCK
latex
V15.07 Z91.040
64450
PERIPHER BLOCK
dye
V15.08 Z91.041
29550
baddy tap
other not me V15.09 Z91.048
23650
SHOULDER
G0378
V58.32 51701
OBS
stright
AS PER CLIENT UPDATE

HENCE EDPACE IS NOT
KINDLY SUGGEST
SPLINTS
INTUBATION
CPR
OCL splint
Etomidate (Amidate)
Ketamine (Ketalar)
Propofol (Diprivan
Norepinephrine
Velcro
Succinylcholine
Rocuronium
Mivacurium
Fentanyl
LEVOPHED
Atropine
ATROPEN
Adenosine
ADENOCARD
Dopamine
Knee immobilizer (long leg)

Posterior splint
Thumb spica (short arm splint)
Orthoglass, plaster
Gel splint
Aircast ankle/foot (short leg)
Lidocaine (Xylocaine)
Atropine
Midazolam
Thiopental
No US brand nam Moonboot (short leg)
Amiodarone
CORDARONE
Epinephrine
ADRENALIN
Vasopressin
VASOSTRICT
Naloxone
EVZIO
Lidocaine
XYLOCAINE
Phenytoin
DILANTIN
nitroprusside
NITROPRESS
nitroglycerin
NITRO-DUR
esmolol
BREVIBLOC
AS PER CLIENT UPDATE NON NARCOTIC IM WARRENTS LEVEL FOR FACILITY SIDE 99283
HENCE EDPACE IS NOT ACCPETING
KINDLY SUGGEST
PAIN
RT
Sprain
LT
RT
Contus
LT
RT
Shoulder M25.511 M25.512
ankle/de
ltoid S93.401A S93.402A
Elbow
Wrist
M25.521 M25.522
M25.531 M25.532
Cervical S13.4XXA
Elbow S53.401A S53.402A
back/tho
M25.551 M25.552
M25.561 M25.562
racic
spine S23.3XXA
Finger
index S63.610A S63.611A
back
front
low back
Middle
Ring
Little
other
Buttock/
lumbar
region/p
elvic
Ear
Elbow
Forearm
hip
Knee
ankle
M25.571 M25.572
arm
Leg
M79.601 M79.602
M79.604 M79.605
Upper armM79.621
Forearm M79.631
hand
M79.641
finger
PAL
M79.622
M79.632
M79.642
M79.645
thigh
M79.651 M79.652
Lower leg M79.661 M79.662
foot
M79.671 M79.672
Toe
M79.674 M79.675
Buttock
M53.3
S63.612A S63.613A
S63.614A S63.615A
S63.616A S63.617A
S63.618A xxxxx
thumb S63.601A S63.602A

Knee S83.91XA S83.92XA
Wrist S63.501A S63.502A
other
sprain of
knee &
lig
S86.211A
RT
LT
S91.331A S91.332A
S61.230A
S61.232A
S61.234A
S61.236A
S51.831A
S61.431A
S61.231A
S61.233A
S61.235A
S61.237A
S51.832A
S61.432A
S30.0XXA
S00431A
S50.01XA
S50.11XA
Face/hea
d
S00.83XA
Finger
Index
S60.021A
Little
S60.051A
Middle
Ring
Thumb
Puncture
Foot
Finger
Index
Middle
Ring
Little
Elbow
Hand
Ankle
S90.01XA
chest
wall/che
st/
frontal
thorax
S20.219A
Thorax S20.20XA
S60.031A
S60.041A
S60.011A
Contusion
LT
S90.02XA
laceration
RT
LT
Foot/heelS90.31XA S90.32XA
RT
Shoulder S41.011A S41.012A S41.019A
Wrist
Forehead/S00.83XA
Hand
S60.221A S60.222A
S20.20XA
Wrist
Head
Hip
S60.211A S60.212A
S00.93XA
S70.01XA S70.02XA
LT
S61.511A S61.512A S61.519A
Elbow S51.011A S51.012A S51.019A

Forearm S51.811A S51.812A S51.819A
Hand S61.411A S61.412A S61.419A
Finger
Thumb S61.011A S61.012A S61.019A
S30.0XXA
S00.432A
S50.02XA
S50.12XA
Knee
S80.01XA S80.02XA
Lower legS80.11XA S80.12XA
Lip
S00.531A
Mouth S00.532A
S00.83XA
Nasal
Neck
orbital &
Scalp
S60.022A
S60.052A
S60.032A
S60.042A
S60.012A
S00.33XA
S10.99XA
S05.11XA S05.12XA
S00.03XA
Shoulder S40.011A S40.012A

Thigh
S70.11XA S70.12XA
arm upperS40.021A S40.022A
Index S61.210A S61.211A

Middle S61.212A S61.213A
Ring S61.214A S61.215A
Little
S61.216A S61.217A
Thigh S71.111A S71.112A S71.119A

Knee S81.011A S81.012A
Leg (lower)S81.811A S81.812A S81.819A
Foot
S91.311A S91.312A S91.319A
Toes
Great
S91.119A
S91.111A S91.912A S91.113A
Lesser S91.114A S91.115A S91.116A
laceration
RT
LT
Cheek S01.411A S01.412A S01.419A
Ear
S01.311A S01.312A S01.319A
Eyebrow/eyelid
S01.111A S01.112A S01.119A
Forehead S01.81XA
Lip
S01.511A
chin/other parts of
S01.81XA
head
Nose
S01.21XA
Ocular NOS (eye)

Mouth/oral cavity
S01.512A
Scalp S01.01XA
FACE NECS01.81XA
PRESCRIPTION ( Rx )
Vasoactive Medications
Mupirocin topical
Adenosine (adenocard)
Benzocaine topical
Amiodarone
Penicillin v potassium
Hydralazine (Apresoline)
Acetaminophen hydrocodone
Atropine
Docusate (or) colace
Cardizem (Diltiazem)
Polymixin B- trimethoprim opthalmicDilantin (Phenytoin)
fioricet
Dopamine (Intropin)
Rantidine
Dobutamine (Dobutrex)
Sulfamethoxazole trimethoprim ( BaEpinephrine
Ciprofloxacin otic
Labetalol
Flonace
Levophed (Norepinephrine)
Loratidine pseudoephedrine ( mixedLidocaine IV
Keflex (cephalexin)
Lopressor (Metoprolol)
Hydrocortisone
Magnesium GTT
Hydroxyzine hydrochloride
Nystatin topical
Amoxicillin clavulanate
Mannitol
Phenylephrine (Neosynephrine) IV
Nitroprusside (Nipride) NTG
(nitroglycerine) IV
Antipyxin -benzocaine otic

Mon felukast (5 mg)
Gentamycin ointment / solu
Chlorhexidine topical ( peridex )
Ofloxacin opthalmic
Galabentin
Mupirocin ( Barboban )
Ciconazole topical
Griseoflavin microcrystalline
Dexamthasone (3mg)
Decadron
Griseofluvin
Ketoconazole
Pepsid (famotidine)
Methocarbamol ( Robarin)
Prednisolone
Permethione topical
Omeprazole- sodium bicarbonate
Acetaminophen hydrocodone
Lotrimin cream ( Clotrimazole topical )
Cefitidinir
Lisdexamfetamine
Meclizine
Naproxen
Augmentin
Permethin (Elimite)
PCS
IVP,IM,SC
Ativan (Lorazepam)
Demerol (Meperidine)
Dilaudid (Hydromorphone)
Etomidate
Fentanyl
Haldol (Haloperidol)
Morphine
Nubain
Stadol
Succinylcholine
Valium (Diazepam)
Versed
Sucralfate
Omeprazole (>20mg)
Budesonide farmatool (Symbicort inhalation)
Acyclovir
Labetalol ( HTN ) drug
Enalapril
Cholecalciferol, Enfamil
Cefpodoxime
Zincoxide
Vermectin
Benzocaine dextromethorphan ( Cepacol ) Rx
Bacitracin opthalmic
Lansoprazole
Prenatal vitamin
Benzepril
Metformin
Glipizide
Lacrilube
Acyclovir
Xanax
Tizanidine
Keppra ( levetiracetam )
Cefixime
Clotrimazole
Ketaconazole, Antidandruf shampoo (2%).
Motrin 600mg or 800mg
Albuterol inhaler
Atrovent inhaler
Prednisone
Lortab (Hydrocodone & Tylenol)
Tylenol #3 (Codeine)
Perocet (Oxycodone & Tylenol)
Phenergan
Keflex
Penicillin
Fiorcet
Protonix
Nexium
(OTC)
Given by mouth (PO)
Motrin / Ibuprofen (600mg and 800mg is prescription strength)
Colace (Docusate Sodium)
Claritin
Zyrtec
Benadryl
Senna (Senakot)
Tylenol (Acetaminophen)
Fleets Enema / Soap Suds Enema
Prilosec
Zantac
Miralax
Milk of Magnesia
PROCEDURE
TYPE
CPT
Incision & Drainage
Simple or single abscess
10060
Incision & Drainage
Splint
Incision & Drainage
Complex or multiple, gauze packing,

exploring or breaking up of loculations, 10061
drain tube placement
Perianal abscess
46050
Incision & Drainage
Scrotal abscess(scrotal space)
54700
Splint
Incision & Drainage
Perirectal abscess
46040
Splint
Incision & Drainage
Vulva or Perineal or Labia
56405
Splint
Incision & Drainage
Peritonsillar abscess
42700
Strapping
Incision & Drainage
Bartholins abscess
56420
Incision & Drainage
Eyelid abscess
67700
Incision & Drainage
Dentoalveolar abscess
41800
Incision & Drainage
Finger abscess
10060 OR
10061
Incision & Drainage
Pilonidal cyst
10080
For external hemorrhoid
46083
For external hemorrhoid
46320
Incision & Drainage
Hematoma, Seroma or Fluid Collection
10140
Incision & Drainage
Postoperative wound Infection
10180
Foreign Body Removal *

(Incision not required)*
Foot (superficial)
28190
Foot (deep)
28192
Simple
10120
Complex
10121
Pharynx
42809
Foreign Body Removal
Conjunctiva (superficial)
65205
Conjunctiva (embedded)
65210
Cornea (without slit lamp)
65220
Cornea (with slip lamp)
65222
Ear(auditory canal)
69200
Nose
30300
Vestibule of mouth (simple)
40804
Incision of thrombosed
hemorrhoid
Excision of thombosed
hemorrhoid
Incision & Foreign Body

removal
Incision & Foreign Body
removal
Splint
Vestibule of mouth (complex)
40805
Impacted cerumen removal
*unilateral
69210
Puncture Aspiration
10160
CPR
92950
Endotracheal Intubation
31500
Central line placement
36555 or
36556
(based on
age)
*Catheter placement
Intraosseous line placement
36680
Peripheral line placement
*Catheter placement
36568 or
36569
(based on
age)
Arterial line placement
*Catheter placement
36620
Venipuncture
36415
Foley catheter placement
51702
Electrocardioversion
92960
Lumbar puncture
62270
Epistaxis (anterior)
Epistaxis (posterior)
Simple (cauterization or cotton balls

used)
Complex (rhino rocket, nasal tampon
used)
30901
30903
30905
Abdominal Paracentesis
Without Imaging
49082
Abdominal Paracentesis
With Imaging
49083
Thoracentesis
Without Imaging
32554
Thoracentesis
With Imaging
32555
Chest tube placement
32551
Laryngoscopy
31505
Anoscopy
46600
Nasal Fracture
Fracture care
21310
Clavicle Fracture
Fracture care
23500
Finger Fracture
Distal phalanx
26750
Finger Fracture
Proximal or Middle phalanx
26725
Toe Fracture
Great Toe
28490
Toe Fracture
Other than Great Toe
28510
Metacarpal Fracture
Fracture care
26600
Metatarsal Fracture
Fracture care
28470
Shoulder Dislocation
Without Anesthesia
23650
Interphalangeal Joint
Dislocation
Without Anesthesia
26770
Metacarpophalangeal Joint
Dislocation
Without Anesthesia
26700
Elbow Dislocation
Without Anesthesia
24600
Nurse maids elbow
24640
Hip Dislocation
Traumatic
27250
Hip Dislocation
Post Hip Arthroplasty
27265
Ankle Dislocation
Without Anesthesia
27840
Patella Dislocation
Laceration repair (MCR
patient)
Without Anesthesia
27560
Dermabond placed
G0168
Laceration repair (Postop)
Superficial Wound Dehiscence
12020 or
12021
Debridement alone
97597
Nail removal
11730
Nail excision
11750
Nail excision + amputation
11752
Trephination or Evacuation of
e.g., subungual hematoma
hematoma
11740
Nail bed repair
11760
Wedge excision
e.g., ingrown toe nail
11765
Vermillion border repair
*should be layered closure
40650
Peripheral/Digital nerve
block
Dental nerve block
64450
64400
Trigger point injection

Arthrocentesis/Injection/Aspir
Joint/Bursa(toes,fingers)
ation
Arthrocentesis/Injection/Aspir Joint/Bursa(TMJ, AC joint, wrist, elbow,
ation
ankle, olecranon)
Arthrocentesis/Injection/Aspir Joint/Bursa(shoulder, hip, knee,
ation
subacromial bursa)
20552
20600
20605
20610
Ultrasounds(Based on the client)

Abdomen
76705
Renal (Kidney), Aorta
76775
Cardiac
93308
Thoracic or Chest
76604
Ocular
76512
Head and neck
76536
Pelvic(non-obstetric)
76857
Pelvic(Obstetric)
76815
Extremity (soft tissue)

Bladder scan(Post-void
residual)
Extremity(soft tissue) for
evaluation of DVT
76882
Breast
76642
For vascular access

For needle placement
51798
93971
Ultrasound Guidance
e.g., Catheter placement(venous or
arterial)
e.g., biopsy, aspiration, injection,
localization device
Long arm ( upto

elbow)
Short arm (below
elbow, forearm,
hand)
Finger or aluminium
foam
Long leg (complete
LE)
Short leg (below
knee)
29105
29125
29126 DYNAMIC
Description
Arterial line
Arthrocentesis;
(catheterization)
Arterial
puncture
(ABG)
Arthrocentesis;
TMJ,
fingers/toes
Arthrocentesis; shoulder,
wrist, elbow,
hip or knee
acromioclavicular or
ankle
29130
Burn debridement
29505
Burn dressing
Central line (age 5 and
over)
29515
Ankles
29540
Central line (under age 5)
Toe
29550
Cerumen Removal
Chest tube
Moderate sedation
CPR
Debridement, skin
Dental block
Digital block
EKG interpretation
ET tube
FB conjunctiva
FB cornea w/out slit lamp
FB cornea with slit lamp
Fb from Ext Aud canal
FB foot; subcutaneous
FB nose
FB pelvis/hip;
subcutaneous
FB shoulder;
subcutaneous
FB skin
FB upper arm/elbow;
subcutaneous
Gastrostomy tube change
I&D abscess
I&D abscess, complicated
I&D Bartholin's gland

abscess
I&D blister
I&D cyst (except pilonidal)
I&D cyst (except
pilonidal), comp
I&D dental abscess
I&D eyelid abscess
I&D external ear abscess
I&D finger abscess
I&D finger abscess,
complicated
I&D furuncle
I&D furuncle, complicated
I&D hematoma
I&D paronychia
I&D paronychia,
complicated
I&D perirectal abscess
I&D pilonidal cyst
I&D pilonidal cyst,
complicated
I&D postop infection,
complicated
I&D seroma
Impacted cerumen
removal
Incision of external
hemorrhoid
Lumbar puncture
Nail bed repair
Nail removal
Nasal packing/cautery,
anterior
anterior, extensive
posterior, initial
posterior, subsequent
NG tube
Percardiocentesis
PICC line (age 5 and over)
PICC line (under 5)
Placenta delivery only
Pulse oximetry
Pulse oximetry, multiple
Puncture aspiration of
abscess
Rhythm strip
interpretation
Rust ring removal
Subungual hematoma
evacuation
Temporary
transcutaneous pacing
TPA
Trach tube change
Trigger Point Injection
Urethral catheter (Nonindwelling foley or
straight cath)
Urethral catheter
(Temporary indwelling
foley, simple)
Urethral catheter
(Temporary indwelling
foley, complicated)
Vaginal delivery only
Vermilion
border
repair
Wedge excision
(ingrown
nails)
CPT
36620
36600
20600
20610
20605
16020
16020
36556
36555
69210
32020
99143..
92950
11040
64400
64450
93010
31500
65205
65220
65222
69200
28190
30300
27086
23330
10120
24200
43760
10060
10061
56420
10140
10060
10061
41800
67700
69000
26010
26011
10060
10061
10140
10060
10061
46040
10080
10081
10180
10140
69210
46083
62270
11760
11730
30901
30903
30905
30906
43753
33010
36569
36568
59414
94760
94761
10160
93042
65435
11740
92953
92977
31502
20552
51701
51702
51703
59409
40650
11765
Documentation Requirements
Modifier
-51
exempt by MD/included in CCT
Personally
performed
Can be used
for injection
OR withdrawal
Can be used for injection OR withdrawal
Can be used for injection OR withdrawal
Personally performed by MD
Includes conscious sedation

Performed with instrument
Modifier -51 exempt/includes conscious sedation
See specific documentation guidelines
Includes defibrillation
Do not bill separately from suturing unless extensive
debridement is documented
Modifier -51 exempt
Performed with instrument(See Exam section for slit

lamp usage)
Incision not necessary
Must have incision AND removal
Must have incision AND drainage
Must have incision AND draninage of mulitple sites
or packing or drain

Must have incision AND drainage of multiple sites or
packing or drain
Must have incision AND drainage with debridement
packing or drain
packing or drain
packing or drain
packing or drain
Personally performed by MD with instrument
For thrombosed hemorrhoids
Fluid must be obtained (not blood only)
Includes nail removal
Do not bill separately from nail bed repair/Can be
billed for partial removals
Packing or cautery (1 time)
Must have more than one packing/cautery done
Must cleary state posterior bleed

Must cleary state posterior bleed
Personally performed by MD/included in CCT
Includes conscious sedation
Included in vaginal delivery (59409)
Only bill if medically necessary/included in CCT and
Conscious sedation codes
Only bill if medically necessary/included in CCT and
Conscious sedation codes
Must document PUNCTURE ASPIRATION
Can bill for partial rust ring removal
not required
Modifer -52
Included in CCT/Must indicate result of

procedure/includes conscious sedation.
Personally performed by MD,now billable to MCR
Personally performed by MD, now billable to MCR
Personally performed by MD, now billable to MCR

Episiotomy/placenta delivery included
Vermilion border must be realigned
Must state wedge excision was performed
Facility Master CPTs

CPT Code
21310
21315
21320
21335
21337
21401
21421
21445
21450
21451
21453
21480
21800
21820
22305
23500
23505
23520
23525
23540
23545
23570
23600
23605
23620
23625
23650
23665
24341
24500
24505
24530
24535
24560
24565
24576
24577
24600
24620
24640
24650
24655
24670
24675
25500
25505
25520
25530
25535
25560
25565
25600
25605
25622
25624
25630
25635
25650
25660
25675
25680
25690
26525
26587
26600
26605
26641
26645
26670
26700
26720
26725
26727
26735
26740
26742
26750
26755
26756
26765
26770
26910
26951
27080
27193
27200
27220
27222
27232
27246
27250
27265
27266
27267
27500
27502
27503
27508
27510
27517
27520
27530
27532
27538
27550
27560
27750
27752
27760
27762
27767
27768
27780
27781
27786
27788
27808
27810
27816
27818
27824
27825
27830
27840
28400
28430
28435
28445
28450
28455
28470
28475
28490
28495
28510
28515
28530
28540
28570
28600
28630
28660
28810
28820
28825
29851
Body Area
Ankle
Elbow
Finger
Foot
Hand
Hip
Jaw
Knee
Shoulder
Toe
Wrist
Body Area/Bone
Acetabulum
Ankle
Calcaneus
Carpal
Clavicle
Coccyx
Femur
Fibula
Finger
Humerus
Hyoid
Mandible
Metacarpal
Metatarsal
Nose
Orbit
Patella
Pelvic ring
Radius
Radius and Ulna
Ribs
Scapular
Skull
Sternum
Talus
Tarsal
Tibia
Toe
Ulna
Description
Closed treatment of nasal bone fracture without manipulation

Closed treatment of nasal bone fracture; without stabilization
Closed treatment of nasal bone fracture; with stabilization
Open treatment of nasal fracture; with concomitant open treatment of fractured septum
Closed treatment of nasal septal fracture, with or without stabilization
Closed treatment of fracture of orbit, except blowout; with manipulation
Closed treatment of palatal or maxillary fracture with wire fixation or fixation of denture or splint
Open treatment of mandibular or maxillary alveolar ridge fracture
Closed treatment of mandibular fracture; without manipulation
Closed treatment of mandibular fracture; with manipulation
Closed treatment of mandibular fracture with interdental fixation
Closed treatment of temporomandibular dislocation; initial or subsequent
Closed treatment of rib fracture; uncomplicated, each
Closed treatment of sternum fracture
Closed treatment of vertebral process fracture(s)
Closed treatment of clavicular fracture, without manipulation
Closed treatment of clavicular fracture; with manipulation
Closed treatment of sternoclavicular dislocation; without manipulation
Closed treatment of sternoclavicular dislocation; with manipulation
Closed treatment of acromioclavicular dislocation; without manipulation
Closed treatment of acromioclavicular dislocation; with manipulation
Closed treatment of scapular fracture; without manipulation
Closed treatment of proximal humeral fracture (surgical or anatomical neck); without manipulation
Closed treatment of proximal humeral fracture; with manipulation, with or without skeletal traction
Closed treatment of greater humeral tuberosity fracture; without manipulation
Closed treatment of greater humeral tuberosity fracture; with manipulation
Closed treatment of shoulder dislocation, with manipulation; without anesthesia
Closed treatment of shoulder dislocation, with fracture of greater humeral tuberosity, with manipulation
Repair, tendon or muscle, upper arm/elbow, each tendon/muscle, primary or secondary
Closed treatment of humeral shaft fracture; without manipulation
Closed treatment of humeral shaft fracture; with manipulation, ith or without skeletal traction
Closed treatment of supracondylar or transcondylar humeral fracture, with or without intercondylar extension; with
Closed treatment of supracondylar or transcondylar humeral fracture, with or without intercondylar extension; with
skin or skeletal traction
Closed treatment of humeral epicondylar fracture, medial or lateral; without manipulation
Closed treatment of humeral epicondylar fracture, medial or lateral; with manipulation
Closed treatment of humeral condylar fracture, medial or lateral; without manipulation
Closed treatment of humeral condylar fracture, medial or lateral; with manipulation
Treatment of closed elbow dislocation; without anesthesia (no Nursemaids elbow)

Closed treatment of Monteggia type of fracture dislocation at elbow (fracture proximal end of ulna with dislocation
Closed treatment of radial head subluxation in child, nursemaid elbow, with manipulation
Closed treatment of radial head or neck fracture; without manipulation
Closed treatment of radial head or neck fracture; with manipulation
Closed treatment of ulnar, proximal end (e.g. olecranon or coronoid process); without manipulation
Closed treatment of ulnar fracture, proximal end (eg. olecranon or coronid process); with manipulation
Closed treatment of radial shaft fracture; without manipulation
Closed treatment of radial shaft fracture, with manipulation
Closed treatment of radial shaft fracture and closed treatment of dislocation of distal radioulnar joint (Galeazzi fract
Closed treatment of ulnar shaft fracture; without manipulation
Closed treatment of ulnar shaft fracture; with manipulation
Closed treatment of radial and ulnar shaft fractures; without manipulation
Closed treatment of radial and ulnar shaft fractures; with manipulation
Closed treatment of distal radial fracture (e.g. Colles or Smith) or epiphyseal separation, includes closed treatment o
manipulation
Closed treatment of distal radial fracture (e.g. Colles or Smith) or epiphyseal separation, includes closed treatment o
manipulation
Closed treatment of carpal scaphoid (navicualr) fracture; without manipulation

Closed treatment of carpal scaphoid (navicular) fracture; with manipulation
Closed treatment of carpal bone fracture (excluding carpal scaphoid); without manipulation, each bone
Closed treatment of carpal bone fracture; with manipulation, each bone
Closed treatment of ulnar styloid fracture
Closed treatment of radiocarpal or intercarpal dislocation, one or more bones, with manipulation
Closed treatment of distal radioulnar dislocation with manipulation
Closed treatment of trans-scaphoperilunar type fracture dislocation w/ manipulation
Closed treatment of lunate dislocation, with manipulation
Capsulectomy or capsulotomy; interphalangeal joint, each joint
Reconstruction of polydactylous digit, soft tissue and bone
Closed treatment of metacarpal fracture, single; without manipulation each bone
Closed treatment of metacarpal fracture, single; with manipulation each bone
Closed treatment of carpometacarpal dislocation, thumb; with manipulation
Closed treatment of carpometacarpal fracture dislocation, thumb; with manipulation (Bennett fracture)
Closed treatment of carpometacarpal dislocation, other than thumb, with manipulation, each joint; without anesthes
Closed treatment of metacarpophalangeal dislocation, single, with manipulation, without anesthesia
Closed treatment of phalangeal shaft fracture, proximal or middle phalanx, finger or thumb; without manipulation,
Closed treatment of phalangeal shaft fracture, proximal or middle phalanx, finger or thumb; with manipulation, wi
each
Percutaneous skeletal fixation of unstable phalangeal shaft fracture, proximal or middle phalanx, finger or thumb, w
Open treatment of phalangeal shaft fracture, proximal or middle phalanx, finger or thumb, includes internal fixation
Closed treatment of articular fracture, involving metacarpophalangeal or interphalangeal joint; without manipulatio
Closed treatment of articular fracture, involving metacarpophalangeal or interphalangeal joint; with manipulation, e
Closed treatment of distal phalangeal fracture, finger or thumb; without manipulation, each
Closed treatment of distal phalangeal fracture, finger or thumb; with manipulation, each
Percutaneous skeletal fixation of distal phalangeal fracture, finger or thumb, each
Open treatment of distal phalangeal fracture, finger or thumb, includes internal fixation, when performed, each
Closed treatment of interphalangeal joint dislocation; single, with manipulation; without anesthesia
Amputation, metacarpal, with finger or thumb (ray amputation), single, with or without interosseous transfer
Amputation, finger or thumb, primary or secondary, any joint or phalanx, single, including neurectomies; with direc
Coccygectomy, primary
Closed treatment of pelvic ring fracture, dislocation, diastasis or subluxation; without manipulation
Closed treatment of coccygeal fracture
Closed treatment of acetabulum (hip socket) fracture(s); without manipulation
Closed treatment of acetabulum (hip socket) fracture(s); with manipulation, with or without skeletal traction
*REQUIRES COMPLIANCE REVIEW Closed treatment of femoral fracture, proximal end, neck; with manipulation,
Closed treatment of greater trochanteric fracture, without manipulation
Closed treatment of hip dislocation, traumatic; without anesthesia
Closed treatment of post hip arthroplasty dislocation; without anesthesia
Closed treatment of post hip arthroplasty dislocation; requiring regional or general anesthesia
Closed treatment of femoral fracture, proximal end, head; without manipulation
Closed treatment of femoral shaft fracture, without manipulation
Closed treatment of femoral shaft fracture, with manipulation, with or without skin or skeletal traction
Closed treatment of supracondylar or transcondylar femoral fracture, with or without intercondylar extension; with
skin or skeletal traction
Closed treatment of femoral fracture, distal end, medial or lateral condyle, without manipulation
Closed treatment of femoral fracture, distal end, medial or lateral condyle, with manipulation
Clsd treatment distal femoral epiphyseal separation; w/ manipulation with or w/o skeletal traction
Closed treatment of patellar dislocation; without manipulation
Closed treatment of tibial fracture, proximal (plateau); without manipulation
Closed treatment of tibial fracture, proximal (plateau); with or without manipulation, with skeletal traction
Closed treatment of intercondylar spine(s) and.or tuberosity fracture(s) of knee, with or without manipulation
Closed treatment of knee dislocation; without anesthesia
Closed treatment of patellar dislocation; without anesthesia
Closed treatment of tibial shaft fracture (with or without tibial fibular fracture); without manipulation
Closed treatment of tibial shaft fracture (with or without tibial fibular fracture); with manipulation, with or without
Closed treatment of medial malleolus fracture, without manipulation
Closed treatment of medial malleolus fracture; with manipulation, with or without skin or skeletal traction
Closed treatment of posterior malleolus fracture; without manipulation
Closed treatment of posterior malleolus fracture; with manipulation
Closed treatment of proximal fibula or shaft fracture; without manipulation
Closed treatment of proximal fibula or shaft fracture; with manipulation
Closed treatment of distal fibular fracture (lateral malleolus); without manipulation
Closed treatment of distal fibular fracture (lateral malleolus); with manipulation
Closed treatment of bimalleolar ankle fracture; without manipulation

Closed treatment of bimalleolar ankle fracture; with manipulation
Closed treatment of trimalleolar ankle fracture; without manipulation
Closed treatment of trimalleolar ankle fracture; with manipulation
Closed treatment of fracture of weight bearing articular portion of distal tibia (eg, pilon or tibial plafond), with or w
manipulation
Closed treatment of fracture of weight bearing articular portion of distal tibia, with or without anesthesia; with skele
manipulation
Closed treatment of proximal tibiofibular joint dislocation; without anesthesia
Closed treatment of ankle dislocation; without anesthesia
Closed treatment of calcaneal fracture; without manipulation
Closed treatment of talus fracture; without manipulation
Closed treatment of talus fracture; with manipulation
Open treatment of talus fracture, includes internal fixation, when performed
Treatment of tarsal bone fracture (except talus and calcaneus); without manipulation, each
Treatment of tarsal bone fracture (except talus and calcaneus); with manipulation, each
Closed treatment of metatarsal fracture; without manipulation, each
Closed treatment of metatarsal fracture; with manipulation, each
Closed treatment of fracture great toe, phalanx or phalanges; without manipulation
Closed treatment of fracture great toe, phalanx or phalanges; with manipulation
Closed treatment of fracture, phalanx or phalanges, other that great toe; without manipulation, each
Closed treatment of fracture, phalanx or phalanges, other that great toe; with manipulation, each
Closed treatment of sesamoid fracture
Closed treatment of tarsal bone dislocation, other than talotarsal; without anesthesia
Closed treatment of talotarsal joint dislocation; without anesthesia
Closed treatment of tarsometatarsal joint dislocation; without anesthesia
Closed treatment of metatarsophalangeal joint dislocation; without anesthesia
Closed treatment of interphalangeal joint dislocation; without anesthesia
Amputation, metatarsal, with toe, single
Amputation, toe; metatarsophalangeal joint
Amputation, toe; interphalangeal joint
Arthroscopically aided treatment of intercondylar spine(s) and/or tuberosity fracture(s) of the knee, with or withou
external fixation (includes arthroscopy)
Proximal
Distal
Shaft
Dislocations
Anatomical Site
Shoulder
Ankle
Nursemaid's Elbow (6 and under)
Radial Head (over 6)
Metatarsophalangeal
Talotarsal Joint
Tarsal Bone Alone
Tarsometatarsal Joint
Metacarpophalangeal
Hip Prosthesis
Hip - Traumatic
TMJ - Temporomandibular Joint
Knee (Anterior, Posterior)
Patella
Proximal Tibiofibular Joint
Acromioclavicular (AC) *** See Below
(Anterior, Inferior, Posterior)
Sternoclavicular Joint
Carpometacarpal Joint at Thumb
Carpometacarpal Joint not at Thumb
Lunate
Radiocarpal or Intercarpal
Distal radioulnar
sling.
Anatomical specifics
Hip socket
Bimalleolar
Lateral Malleolus (Avulsion Fx of ankle)
Medial Malleolus
Trimalleolar
Max 1
Scaphoid (navicular-wrist)
Any site
Proximal or neck
Intertrochanteric, pertrochanteric
or subtro
Greater trochanteric
Shaft
Supracondylar/transcondylar
Distal (medial or lateral condyle)
Proximal or shaft
Distal (lateral malleolus)
Phalangeal - Distal (Max 1)
Phalangeal - Shaft (Proximal
or Middle Phalanx) (
Interphalangeal or Metacarpophalangeal (Max 1)
Proximal
Greater tuberosity
Shaft
Medial or lateral epicondylar
Medial or lateral condylar (Distal Humerus)
Supracondylar/transcondylar
Boxer's fracture (Max 1)

Max 1
Nasal Bone
Nasal Septum
Excludes blowout fracture
Proximal (Head or neck)

Distal Radial (Colles/Smith type)
Shaft
Proximal (Head or neck) with ulna
Distal radius (Colles/Smith) with ulna
Shaft of radius and ulna
Ribs (Max 1) **Do not use
mod -54 with GA Mcaid
Cuboid, Cuneiforms, and Navicular-ankle

Calcaneus
Talus
Proximal (plateau)
Distal
Shaft
With Fibula (distal)
With Fibula (shaft)
Great Toe PIP/DIP
Toe (other than Great) PIP/DIP (Max 1)
Proximal
Styloid
Shaft
MIS IV HYD,INFU STOP TIME
MIS IV HYD STOP TIME
AS PER CLIENT UPDATE NON NARCOTIC IM WARRENTS LEVEL 99283 FOR FACILITY SIDE HENCE EDPACE I
SUGGEST
TPG 35
THE PATIENT WAS SEEN IN MAIN ED HENCE DEPARTMENT FEILD IN EDPAC ESHOWING MAINED/CDU K
DEPARTMENT FEILD TO MAIN ED
THE PATIENT WAS SEEN IN MAIN ED HENCE DEPARTMENT FEILD IN EDPACE SHOWING BLANK KINDLY
OBS HOURS DOCCUMENTED <4 HOURS
AS PER NON MEDICARE GUIDLINES WE SHOULD CODE THESE #ACC WITH E/M LEVEL HENCE IN EDPAC
SHOWING MAINED/CDU
SO KINDLY CHANGE THE DEAPRTMENT FEILD TO MAIN ED
OBS HOURS DOCCUMENTED <8 HOURS AS PER MEDICARE GUIDLINES WE SHOULD CODE THESE #ACC W
EDPACE DEPARTMENT FEILD SHOWING MAINED/CDU
SO KINDLY CHANGE THE DEAPRTMENT FEILD TO MAIN ED
TPG 39
IN THIS ACCOUNT BOTH MAINED/CDU AN CC DOCCUMENTED AS PER CLINENT GUIDLINES WE SHOUL
HENCE DEPARTMENT FEILD IN EDPACE SHOWING MAINED/CDU
KINDLY CHANGE THE FEILD TO MAIN ED
Procedure Code
27840-54
24640
24600-54
28630
28570-54
28540-54
28600-54
26700-54
27265-54
27250-54
21480
27550-54
27560-54
27830-54
23545-54
23650-54
23525-54
28660
26641-54
26670-54
25690-54
25660-54
25675-54
With
27222-54
27810-54
27788-54
27762-54
27818-54
28405-54
25635-54
25624-54
23505-54
N/A
Without
27220-54
27808-54
27786-54
27760-54
27816-54
28400-54
25630-54
25622-54
23500-54
27200-54
27232-54
27240-54
N/A
27502-54
27503-54
27510-54
27781-54
27788-54
26755-54
26725-54
26742-54
23605-54
23625-54
24505-54
24565-54
24577-54
24535-54
21494-54
21451-54
26605-54
28475-54
21315
21337-54
21401-54
N/A
N/A
24655-54
25605-54
25505-54
24655-54
25605-54
25565-54
N/A
23575-54
N/A
N/A
28435-54
28455-54
28405-54
28435-54
27532-54
27230-54
27238-54
27246-54
27500-54
27501-54
27508-54
27780-54
27786-54
26750-54
26720-54
26740-54
23600-54
23620-54
24500-54
24560-54
24576-54
24530-54
21493-54
21450-54
26600-54
28470-54
21310
N/A
21400-54
27520-54
27193-54
24650-54
25600-54
25500-54
24650-54
25600-54
25560-54
21800-54
23570-54
21300
21820-54
28430-54
28450-54
28400-54
28430-54
27530-54
27825-54
27752-54
27810-54
27752-54
28495-54
28515-54
24675-54
N/A
25535-54
27824-54
27750-54
27808-54
27750-54
28490-54
28510-54
24670-54
25650-54
25530-54
Anagesh Logix*123
CPT CHEAT SHEET

Fracture Care (no anesthesia)
23500
Clavicle
27200
Coccyx
26755
Finger (distal w/ manipulation)
26750
Finger (distal)
26725
Finger (mid/prox w/ manipulation)
26720
Finger (middle/proximal)
26740
MP or IP joint articular (Finger)
28490
Great toe
28495
Great toe (w/ manipulation)
26600
Metacarpal (only if NO 1-5 day specialty f/u)
26605
Metacarpal (w/ manipulation)
28470
28475
21310
-54 if applicable
Metatarsal (only if NO 1-5 day specialty f/u)

Metatarsal (w/ manipulation)
Nasal (can bill displaced if not referred to specialty)
21800
Rib
21820
Sternum
28510
Toe
28515
Toe (w/ manipulation)

Dislocations (no anesthesia)
23540
A/C seperation
26770
Interphalangeal finger
28660
Interphalangeal toe
21480
Mandibular
24640
Nursemaid's elbow (< or = 3 yrs)
27560
Patella
27265
Prosthetic hip
23650
Shoulder
27250
Traumatic hip dislocation
24600
elbow dislocation
-54 if applicable
*Splints
29130
Finger (aluminum)
29105
Long arm
29505
Long leg
29125
Short arm (thumb spica/ulnar gutter/volar)

Short leg (Robert Jones/posterior)
29515
Strapping procedures
29580
Unna boot
29280
Strapping of Finger
29550
Strapping of Toe
Arthrocentesis
20610
20605
20600
Large joints (knee/shoulder/hip/sacroiliac

Medium joints (Wrist/elbow/AC/ ankle/TMJ)
Small joints (fingers & toes)
Trigger Point Injections
20550
Ligaments (single tendon sheath eg. plantar fascia)
20552
Muscle (single/mult injection) 1 or 2 muscles

Other procedures
17250
17110
Granulation of skin tissue

Destruction of skin tag, warts, bening lesion
54220
Irrigatation of Priapism
11765
Wedge excision of ingrown nail.
94760
Pulse oximetery
54450
Paraphimosis Reduction, foreskin manipulation.
93041
Rhythm Strip
51702
Foley Catheter
46600
Anascopy
59409
Vaginal Delivery
36430
Blood and blood products
Cast/splint/strapping
Documentation requirements
Ace wrap ankle
Applied by MD
Ace wrap elbow or wrist
Applied by MD
Ace wrap hand or finger
Applied by MD
Ace wrap knee
Applied by MD
Ace wrap ribs
Applied by MD
Active ankle splint
Applied by MD
Air cast/splint
Applied by MD
Bivalve short arm/short leg
Bivalve long arm/long leg
Bivalve shoulder/hip cast
Bivalve turnbuckle jacket
Bledsoe Short Term Boot
Applied by MD
Boot orthosis
Applied by MD
Buddy tape fingers
Applied by MD
Buddy tape toes
Applied by MD
Cock-up splint
Applied or checked by MD
Equalizer Boot
Applied by MD
EZ wrap ankle
Applied by MD
EZ wrap wrist
Applied by MD
Finger splint
Jones wrap - arm
Knee immobilizer
Long arm splint
Long leg splint
Neoprene sleeve
Applied by MD
OCL - arm
OCL - leg
Ortho-glass long arm
Ortho-glass long leg
Ortho-glass short arm
Ortho-glass short leg
Plaster figure of eight
Plaster Velpeau
Posterior long-arm splint
Posterior long-leg splint
Posterior short-leg splint
Post-op shoe
Applied by MD
Removal short arm/short leg cast
Removal long arm/long leg cast
Removal shoulder/hip cast
Removal turnbuckle jacket
Robert Jones (bulky) dressing
Short arm splint
Short leg splint
Shoulder immobilizer
Stirrup ankle splint
Sugar tong - arm
Sugar tong - leg
Thumb spica splint
Ulna gutter splint
Unna boot
Applied by MD
Velcro - arm
Velcro - leg
Velpeau
Applied by MD
Volar arm splint
ALUMA FOAM SPLINT
CPT CHEAT SHEET

FB Removal
46608
69210
Anal
Cerumen (Do not use if lavage/irrigation only)
65205
Conjuctiva
65220
65222
Cornea NO slit lamp

Cornea W/ slit lamp
69200
Ear
28190
Foot w/ OR w/out incision
30300
Nose
42809
Pharynx
10120
Skin W/ incision required
23330
Shoulder
I&Ds/Aspiration
56420
Bartholin's gland
41800
Dental alveolar/ Gums/ Dental
10140
Hematoma
40800
Lips/Cheeks/ Vestibule mouth
10160
46050
10081
Needle aspiration (abscess/hematoma/bulla/cyst)

Perianal
Pilondial cyst, comp (multiple; w/packing, drain)
10080
Pilondial cyst, simple
55100
Scrotal wall
10061
Skin, comp (multiple; w/packing, drain)
10060
Skin, simple
46083
Incision of external thrombosed hemorrhoid
56405
Vulva
69000
Ear
69020
Ear canal w/ packing
54700
Epididymitis, testis and/or scrotum
30020
Nasal septal hematoma
20612
42000
Aspiration and/or injection of ganglion cyst any locations

Palate
Miscellaneous
16000
Burn care - 1st degree (local treatment only)
16020
Burn care - 2nd & 3rd degree small (<5% BSA)
16025
Burn care - 2nd & 3rd degree medium (5-10% BSA)
16030
Burn care - 2nd & 3rd degree large (>1 extremity or >10% BSA)
93010
EKG (-76 for additional)
31505
Laryngoscopy - indirect
31525
Laryngoscopy - direct
11730
Nail avulsion, partial/complete
11760
Nailbed repair/debridement of nail
30903
30901
30905
Nasal hemorrhage, anterior complex (packing)

Nasal hemorrhage, anterior simple (cautery)
Nasal hemorrhage, posterior initial (any method)
30906
Nasal hemorrhage, posterior subsequent
99406
Smoking cessation 3-10 min
99407
Smoking cessation >10 min
11740
Subungal hematoma
97597
Wound debridement
46320
excision of hemorrhoid
12020
wound dehiscence
59409
Spontaneous abortion and removed the dead fetus and placenta
11400
excision of benign lesion (depends on length)
Blocks
64400
Dental/perialveolar
64450
Digital
64430
Penile
Code
29540
29260
29280
29530
29200
29540
29540
29700
29705
29710
29715
29540
29580
29280
29550
29125
29540
29540
29260
29130
29125
29505
29105
29505
29530
29125
29515
29105
29505
29125
29515
29049
29058
29105
29505
29515
29540
29700
29705
29710
29715
29515
29125
29515
29105
29515
29125
29515
29125
29125
29580
29125
29515
29240
29125
29130
Critical Procedures
36600
Arterial Puncture (for blood draw)
36555
*Central Line < 5
36556
*Central Line > or =5
99143
* Conscious Sedation < 5
99144
Conscious Sedation > or = 5
99148
Concious Sedation ONLY by our doc <5
99149
Conscious Sedation ONLY by our doc > or =5
99150
Conscious Sedation ONLY by our doc > or =5 each add 30 min
92950
CPR
31605
Cricothyrotomy
92960
Electrical Cardioversion
36680
Intraosseous IV
31500
Intubation
62270
Lumbar Puncture
43752
NG Lavage/NG Placement
33010
Pericardiocentesis
36000
*Peripheral Line
36568
PICC line placement < 5
36569
PICC line placement > or = 5
32551
Thoracostomy/chest tube
36410
Venipuncture (for blood draw)
43760
G-Tube placement
Laceration Repairs
G0168
Medicare simple repair wound adhesive alone

Simple (scalp/neck, axillae, genitalia, trunk, extremities inc hands/feet)
12001
2.5 cm or less
12002
2.6 -- 7.5 cm
12004
7.6 -- 12.5 cm
12005
12.6 --20.0 cm
Simple (face, ears, eyelids, nose, lips, mucous membranes)
12011
2.5 cm or less
12013
2.6 -- 5 cm
12014
5.1 -- 7.5 cm
12015
7.6 -- 12.5 cm
12016
12.6 -- 20.0 cm
*Intermediate (scalp, axillae, trunk, extremities exc. hands/feet)

12031
2.5 cm or less
12032
2.6 -- 7.5 cm
12034
7.6 -- 12.5 cm
12035
12.6 -- 20.0 cm
*Intermediate (neck, hands, feet, ext genitalia)

12041
2.5 cm or less
12042
2.6 -- 7.5 cm
12044
7.6 -- 12.5 cm
12045
12.6 -- 20.0 cm
*Intermediate (face, ears, eyelids, nose, lips, mucous membranes)

12051
2.5 cm or less
12052
2.6 -- 5.0 cm
12053
5.1 -- 7.5 cm
40830
Vestibule of mouth (inner mucosal lining of mouth)

Reduction Procedures
25605
Reduction of Colles fracture(wrist)
27788
Ankle fracture with dislocation and reduction
25535
Closed treatment of Ulnar shaft fracture with manipulation
27265
Prosthetic hip reduction

Rarely Used
43760
Gastrostomy placement/replacement
Suprapubic (Foley) cath insertion w/out bladder aspiration

51702
31502
Trach replacement (tracheostomy)
43753
Gastric lavage
50398
Change of nephrostomy or pyelostomy tube
99281
Suture
removal for
sutures placed at
another facility
99282
99283
OTC meds
single, non core, xray
minor injury, no xray

(e.g. abrasion)
PO prescription meds
accucheck
Discussion of Rx not
given
administration of tetanus
vaccination
systemic symptoms (see
systemic symptoms list)
lacerations
Non blood draw point of
care (POC) testing
including: Strep, RSV, UA,
BHCg, flu swab, etc
Post op (Surgical-not
done in ED) complaints
(wound/drain issues,
constipation, etc)
<5 yr old with vague sx
(fussy, excessive crying,
feeding problems, GERD
or concern for higher risk
problem
not found)
head injury
w/o
observation and serial
exams documented
Data points
Amount and Complexity
# Points
Review and/or order clinic

Review and/or order radiol
Review and/or order medic
Discuss test results with
Independent review of ima
Decision to obtain old rec
Review and summarize old
1
1
1
1
2
1
2
99284
99285
Fever > 103
administration of parenteral
substance
Moderate Conscious Sedation

Specialized Imaging (MRI, CT, VQ
scans, Ultrasound, Doppler) WITH
blood drawn labs OR parenteral
controlled substance/drug requiring
monitoring for toxicity
specialized imaging
(MRI, CT, VQ scans,
Ultrasound) alone
4, or more, data points WITH

parenteral controlled substance OR
drug requiring monitoring for toxicity
EKG
discussion with specialty consultant

WITH 4, or more, data points
blood drawn labs alone
admission/transfer
core x-ray: head and face,

Full Chest pain work-up (EKG WITH
neck, spine, chest, abdomen, one of the following cardiac enzymes:
pelvis, shoulder (including
CK-MB, Troponin, BNP, d-dimer )
clavicle and scapula), and hip
WITH parenteral controlled substance
OR drug requiring monitoring for
nebulizer treatment
toxicity
Pelvic Exam
Fracture ofofbone
Exacerbation
chronic
condition (e.g. asthma, HTN,
head injury etc)
w/ observation
and multiple serial exams
documented
Clonidine PO without testing
MDI treatment in department
diagnosis of concussion
(testing not required)
seizure without testing

WITH facial fracture
Parenteral Controlled S
Ativan (Lorazepam)
Demerol (Meperidine)
Dilaudid (Hydromorphone)
Etomidate
Fentanyl
Morphine
Nubain Stadol
Valium (Diazepam)
Versed
Drugs Requiring Monitoring (IV/IM):

Adenosine (adenocard)
Lidocaine
Activase
Amiodarone
Atropine
Cardizem (Diltiazem)
Dilantin (Phenytoin)
Dobutamine (Dobutrex)
Dopamine (Intropin)
Epinephrine
Geodon
Haldol (Haloperidol)
Heparin
Hydralazine (Apresoline)
Integrillin
Labetalol
Levophed (Noepinephrine)
Lopressor (Metoprolol)
Magnesium GTT
Mannitol
Nitroprusside (Nipride)
NTG Propofol
Phenylephrine (Neo-synephrine)
Streptokinase
Succinylcholine
Thorazine
TNKase (Tenecteplase)
t-PA
Urokinase
Zyprexa
Phosphenytoin
Keppra
Depakote
Vimpat
Phenobarbital
Vasotec
SQ Lovenox
Caffiene
Magnesium
Sodium Bicarb/gluconate
CA Gluconate
AMP D50 glucose
Narcan
Acyclovir
Rhogham
DHE
Nicardipine
Cosynotropin
Calcium Chloride
Systemic Symptoms
Fever < 103

Systemic Rash (or rash of multiple body areas)
Nausea
Vomiting
Diarrhea
Myalgias
Chills
Abdominal Pain
Paresthesia
Anxiety
Weakness
Vertigo/dizziness
Viral Illness or syndrome with Systemic Symptoms (Generally these will have systemic symptoms, the
ETOH or Drug Intoxication
Abnormal involuntary movements
Lethargy
Urinary retention
Excessive crying (adult or child)
Numbness
Restlessness
Sleepiness or Sleeplessness
Fatigue
Constipation
Headache
s, these need confirmation)
MODIFIERS
DESCRIPTION
E/M
25
Significant, separately
identifiable evaluation and
management service by the
same physician on the
same day of the procedure
or other service
Yes
26
Professional Component
No
50
Bilateral Procedure
No
51
Multiple Procedures
No
52
Reduced Services
Yes
54
Surgical Care Only
No
76
Repeat procedure by same

physician
Yes
77
Repeat procedure by
another physician
Yes
SURG
RAD
MED
No
No
No
No
Yes
No
Yes
No
No
Yes
No
No
Yes
No
No
Yes
No
No
Yes
Yes
Yes
Yes
Yes
Yes
NOTES
Service must be above and
beyond the usual level of
care required for a
procedure that is
performed.
Used to denote the

physician component of a
two-component service
(technical and
professional). Procedures
that are 100% professional
(e.g. 93010 Interpretation
and report only) wound not
require this modifier.
Identifies an identical
procedure performed
bilaterally (e.g. chest tubes
inserted into both lungs). If
a procedure states that it is
already classified as
bilateral, do not apply this
modifier. When entering
charges, list code twice
with modifier on the
second code (e.g. 32020
and 32020-50).
This modifier is not used
on -51 modifier exempt
codes or add-on codes.
List the procedure code
with the highest value first
and apply the -51 modifier
to all subsequent
procedures.
Indicates that a service or
procedure was reduced in
some manner (e.g. client
wants to bill a reduced
service on suture
removals).
Used when the physician is
providing the surgical care
only. This modifier is
mainly used for
fracture/dislocation care.
Used when a physician

must repeat a procedure or
service subsequent to the
original procedure.
Used when a physician
must repeat a procedure or
service performed by
another physician.
Anatomical SiteNumber of Views CPT Findings Needed

Medicare
Other
70140-26
70150-26
70160-26
70200-26
70210-26
70220-26
70250-26
70260-26
2
2
2
2
2
2
2
2
1
1
1
1
1
1
1
1
70360-26
71010-26
71020-26
71100-26
71101-26
71110-26
71111-26
71120-26
71130-26
3
3
2
2
2
2
2
2
3
3
1
1
1
1
1
1
2 views
72040-26
2 views
72070-26
2 views
72100-26
flat and upright
72170-26
Complete (at least 3 views72190-26
2
2
2
2
2
1
1
1
1
1
72220-26
2
2
2
2
2
2
2
2
1
1
1
1
1
1
1
1
Notes
Head and Neck
Facial Bones
Facial Bones
Nasal Bones
Orbits
Sinuses
Sinuses
Skull
Skull
Less than 3 Views

At least 3 views
3 views
4 views
Less than 3 Views
At least 3 views
Less than 4 Views
At least 4 views
Neck (soft tissue)

Chest
Chest
Chest
Ribs unilateral
Ribs unilateral
Ribs bilateral
Ribs bilateral
Sternum
Sternum
1 view (frontal or PA)

2 views (PA & Lateral)
2 views
3 views
3 views
4 views
2 views
3 views
Spine and Pelvis
C-spine
Thoracic Spine
Lumbosacral Spine
Pelvis
Pelvis
Sacrum and Coccyx 2 views

Upper Extremities
Clavicle
Scapula
Shoulder
Humerus
Elbow
Forearm
Wrist
Hand
1 view
2 views
2 views
2 views
2 views
2 views
73000-26
73010-26
73020-26
73060-26
73070-26
73090-26
73100-26
73120-26
Fingers
2 views
73140-26
1 view
73500-26
Lower Extremities
Hip, unilateral
Do not bill with critical care

Do not bill with critical care
includes PA chest x-ray
includes PA chest x-ray
Hip, bilateral
Femur
Knee
Tibia/Fibula
Ankle
Ankle
Foot
2 views each hip

2 views
1 or 2 views
2 views
3 views
2 views
2 views
73520-26
73550-26
73560-26
73590-26
73610
73600-26
73620-26
2
2
2
2
1
1
1
1
2
2
1
1
Toes
2 views
73660-26
1 view/KUB
74000-26
Flat and upright
74020-26
Complete acute series (A 74022-26
EKG
93000
Nose to recture
76010
heel
73650
3
3
3
3
3
3
Includes AP of pelvis
Abdomen
Abdomen
Abdomen
Abdomen
includes PA of chest
with critical care

with critical care
chest x-ray
chest x-ray
Sl no
Combo
ICD 9 CM
Pharyngitis + Influenza(FLU)
487.1
Laryngitis + Influenza(FLU)
487.1
Pharyngitis + Influenza A(Avian

FLU)
488.02
Laryngitis + Influenza A(Avian

FLU)
488.02
Pharyngitis + H1N1
488.12
Laryngitis + H1N1
488.12
Acute Bronchitis + COPD
491.22
Bronchiolitis + RSV
466.11
Pneumonia + Influenza
487.0, type of pneumonia code
10
Bronchitis+ Asthma
493.9
11
Emphysema + COPD
491.2
12
Emphysema + COPD + Acute

Bronchitis
491.22
13
Emphysema + Bronchitis
491.2
14
Asthma + COPD
493.2
15
Bronchiectasis + COPD
494
16
Bronchospasm + Asthma
Code only Asthma
17
Bronchospasm + Bronchitis
Code only Bronchitis
18
Bronchospasm + Bronchitis +
Asthma
Code only Asthma
19
Asthma + COPD + Bronchitis
493.2
20
Bronchospasm + Emphysema
Code only Emphysema
CONTUSION
DIABETIC HYPOGLYCEMIA
ACUTE SEROUS OTITIS MEDIA
SEROUS OTITIS MEDIA
ALLERGIC DERMATITIS
E11.649
ELBOW
S50.0
H65.0
HEAD
S00.93XA
H65.9
FOREARM
S50.1
L23.9
EAR
S00.43
N76.0,B96.89
SUBDURAL HEMATOMA TRAUMATIC
S06.5X
BACTERIAL VAGINITIS
POSITIONAL/BENIGN PARO VERTIGO H81.1
ARM/UPPER ARM
S40.02
PENILE DISCHARGE
SUBCONJUCTIVAL HEMMORHAGE
TENDINITIS KNEE
R36.9
H11.3
M76.89
HAND
SHOULDER
LIP
S60.22
S40.01
S00.531
TENDINITIS WRIST
THROMBOCYTOPENIA
ARTHRITIS KNEE
M77.8
D69.9
M13.86
FOOT,HEEL
WRIST
ABDOMINAL
S90.3
S60.21
S30.1
TENDINITIS FOOT
MIGRANE WITH AURA
CALCULUS KID WITH URETER
M77.9
BUTTOCK/COCCYX/LOW BACK
S30.0XXA
G43.109
LOWER LEG
S80.1
N20.2
HIP
S70.0
PERIPHERAL VERTIGO
CHOLECYSTITS
H81.39
K81.9
ACUTE CHOLECYSTITIS
K81.0
LOWER BACK/LUMBAR
PREGNANCY OTHER SPECIFIED 1ST O26.891

EPILEPSY
G40.909
NANCY BACTERIAL VAGINOSIS OR ANY GENITAL
O23.59
INFECTION
BURSITIS HIP
MENINGITIS
M70.7
G03.9
FOLLICULITIS
L73.9
SWELLING EAR
VIRAL CONJUCTIVITIS
BURSITIS ELBOW
VAGINITIS CHLAMIDYAL
APPENDICITIS
ACUTE APPENDICITIS
H93.8
B30.9
M70.3
A56.02
K37
K35.80
FOREIGN BODY
NOSE
T17.1
CARDIAC ARREST
I46.9
UNSTABLE ANGINA
I20.0
HERPES ZOSTER
B02.9
ORAL /MOUTH CANDIDIASIS
B37.0
CANDIDIASIS VAGINA/VUVLA/VUVLOVAGINOITIS
B37.3
PICCLINE
T82.598A
CORONARY ARTERT DISEASE
DIVERTICULITIS/ACUTE
TENDINITIS SHOULDER
I25.10
K57.92
M75.9
DISLOCATION/SUBLUXATION
PATELLA DIS
S83.09
VIRAL EXANTHEM
B09
PREMATURE VENTRICULAR CONTRACTIONI49.3
DECOMPENSATION CARDIAC
I51.9
SUPRAVENTRICULAR TACHYCARDIA
I47.1
ABSCESS
ARM/UPPER LIMB/AXILLARY
ABDOMINAL ABSCESS
DENTAL ABSCESS
BARTHOLIAN GLAND
BREAST
BUTTOCK
L02.41
L02.211
K04.7
N75.1
N61
L02.31
EAR(EXTERNAL)
PERIANAL
PERIODONTAL
PERIPHARYNGEAL
PERITONSILLAR
PILONIDAL ABSCESS
VAGINA
H60.0
K61.0
K05.21
J39.0
J36
L05.01
VAGINITIS
CELLULITIS
CELLULITIS EAR
UPPER ARM/AXILLA CELLULITIS
H60.1
L03.11
CAR
DRIVER
COLLISION
ANIMAL
TRAFFIC
NONTRAFIC
V40.5XXA
V40.0XXA
BUS
TRAFFIC
NONTRAFIC
V44.5XXA
V44.0XXA
CAR
TRAFFIC
NONTRAFIC
V43.52XA
V43.02XA
MV NOS
TRAFFIC
NONTRAFIC
SPECIFIED
V49.40XA
V49.00XA
V49.49XA
PEDAL CYCLE
TRAFFIC
NONTRAFIC
V41.5XXA
V41.0XXA
TRAFFIC
V43.53XA
TRAFFIC
NONTRAFIC
V47.52XA
V47.02XA
TRUCK
TRAFFIC
V44.5XXA
VAN
TRAFFIC
V43.54XA
PICKUP TRUCK
STATIONARY OBJECT
ABRASION
FRACTURE
SPRAIN
ABDOMINAL
ANKLE
ARM(UPPER)
CHEST WALL /THORAX
CORNEA
ELBOW
S30.811
S90.51
S40.81
S20.31
S05.0
S50.31
ANKLE
BIMALLEOLAR
LATERAL MAL
MEDIAL
TRIMALLELOR
ARM/HUMERUS SHAFT
KNEE
LIP
NECK
S80.21
S00.511
S10.91
CLAVICLE
ACROMIAL END
ELBOW
S42.00
S42.03
S42.40
SCALP
THORAX BACK
WRIST
S00.01
S20.41
S60.81
FEMUR
LOWER END/DISTAL
INTERTROCHANTERIC
S72.40
S72.13
HEAD
FINGER
FOREARM
S00.91
S60.41
S50.81
GREATER TROCHAN
LESSER TROCHANTER
NECK
S72.11
S72.12
S72.00
FOREHEAD
LEG
S00.81
S80.81
LOWER BACK/LUMBAR S30.810

SHOULDER
THIGH
THUMB
S40.21
S70.31
S60.31
LACERATION
SCALP
FOREARM LEFT
EYEBROW
ORAL,GUM
THUMB R
FOOT
S01.01XA
S51.812
S01.11
S01.512
S61.011
S91.31
S82.899
THUMB
S82.84
KNEE
S82.6 KNEE LATERAL COLLERAL
S82.5
FINGER
S82.85
LUMBAR STRAIN
S42.30
FIBULA(SHAFT,STYLOID) S82.40
LOWER END/DISTAL
S82.83
FINGER
S62.60
DISTAL
MEDIAL
PROXIMAL
S62.63
S62.62
S62.61
HUMERUS
LOWER END/DISTAL
S42.40
MANDIBLE
S02.609
STRAIN
SHOULDER
BICEPS
KNEE
HAND/WRIST
ABDOMINAL WALL
METACARPAL
GREAT TOE DISTAL

INJURY
ROTATOR CUFF
S92.42
S46.00
CRUSH INKJURY
FINGER
BITE HUMAN/ANIMAL
HAND
S61.45
RAIN
S63.60
S83.9
S83.42
S63.61
S39.012A
RAIN
S46.90
S46.21
S86.81
S66.91
S39.011
INKJURY
S67.1

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SUTURE

long term drug

Analgesics V14.6 Z88.6

Dent pain 525.9

other medica V14.8 Z88.8

unspes med V14.9

V58.69 Z79.899 RBBB

V15.01 Z91.010 Rx refill

V15.02 Z91.011 WOUNDCHEK V58.30

V15.03 Z91.012 sutur remoVal

other not me V15.09 Z91.048

AS PER CLIENT UPDATE

Knee immobilizer (long leg)

No US brand nam Moonboot (short leg)

Shoulder M25.511 M25.512

thumb S63.601A S63.602A

Shoulder S41.011A S41.012A S41.019A

S61.511A S61.512A S61.519A

Elbow S51.011A S51.012A S51.019A

Shoulder S40.011A S40.012A

Index S61.210A S61.211A

Thigh S71.111A S71.112A S71.119A

S91.311A S91.312A S91.319A

Lesser S91.114A S91.115A S91.116A

Cheek S01.411A S01.412A S01.419A

S01.311A S01.312A S01.319A

Ocular NOS (eye)

Antipyxin -benzocaine otic

Incision & Drainage

Simple or single abscess

Incision & Drainage

Incision & Drainage

Complex or multiple, gauze packing,

Incision & Drainage

Scrotal abscess(scrotal space)

Incision & Drainage

Incision & Drainage

Vulva or Perineal or Labia

Incision & Drainage

Incision & Drainage

Incision & Drainage

Incision & Drainage

Incision & Drainage

Incision & Drainage

For external hemorrhoid

For external hemorrhoid

Incision & Drainage

Hematoma, Seroma or Fluid Collection

Incision & Drainage

Postoperative wound Infection

Foreign Body Removal *

Foreign Body Removal

Foreign Body Removal

Foreign Body Removal

Cornea (without slit lamp)

Foreign Body Removal

Cornea (with slip lamp)

Foreign Body Removal

Foreign Body Removal

Foreign Body Removal

Vestibule of mouth (simple)

Incision & Foreign Body

Foreign Body Removal

Vestibule of mouth (complex)