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Commonly used CPT codes for Managed Care Systems, LLC Online Authorizations Submission ALLERGY & IMMUNOLOGY 99203 Consult 99213 Follow Up Visit 95004 & 95024 Skin Testing 95115-95117 Allergy Injections 95165 Allergy Serum 94010, 94060, 94760, 94070 PFT (Pulmonary Function Test) E0601 E0470 K0001 E1399 CPAP BiPAP Wheelchair All Other Items ENDOCRINOLOGY 99203 Consult 99213 Follow Up Visit 60100 & 76942 Ultrasound Guided Thyroid Biopsy CARDIOLOGY 99203 Consult 99213 Follow Up Visit 93015 Treadmill 93224-93227 Holter Monitor 93268-93272 Event Monitor 93000 EKG 93306 Echocardiogram 93325, 93350, 93015, J1250 Stress Echo 78452 Thallium Stress Test 93279-93284 Pacemaker Check ENT 99203 Consult 99213 Follow Up Visit 92557 Audiogram 92567 Tympanometry 31505-31579 Laryngoscopy 31231 Nasal Endoscopy 92504 Ear Microscopy 69210 Removal of Impacted Cerumen FAMILY PLANNING 59840-59841 Elective Abortion 76815 Pelvic Ultrasound 55250 Vasectomy 58671 Tubal Ligation w/ Device 58670 Tubal Ligation w/ Fulguration CARDIOVASCULAR SURGERY 99203 Consult 99213 Follow Up Visit DERMATOLOGY 99203 Consult 99213 Follow Up Visit 11000-11001 Skin Biopies 11400-11446 Benign Lesion Excision 11600-11646 Malignant Lesion Excision 17260-17286 Malignant Lesion Destruction 17000-17004 Pre-malignant Lesion Destruction GASTROENTEROLOGY (GI) 99203 Consult 99213 Follow Up Visit 45378 Colonoscopy1 45380 Colonoscopy w/ Biopsy 43235 EGD 43239 EGD w/ Biopsy 45330 Flexible Sigmoidoscopy 43259 Endoscopic Ultrasound DME E1390 Oxygen Concentrator E0431 Portable Oxygen E0143 Walker with Wheels E0156 Walker Seat E0163 Commode E0260 Hospital Bed E0570 Nebulizer 1 Use the below codes for Medicare patients ONLY: G0121--Screening Colonoscopy not meeting criteria for high risk G0105—Screening Colonoscopy meeting criteria for high risk 06/25/2017 -1- INFECTIOUS DISEASE 99203 Consult 99213 Follow Up Visit PLASTIC SURGERY 99203 Consult 99213 Follow Up Visit NEUROSURGERY 99203 Consult 99213 Follow Up Visit PODIATRY 99203 Consult 99213 Follow Up Visit 11719-11721 Toenail Trimming 11055-11057 Callus Trimming 11750 Excision of Nail & Matrix NEUROLOGY 99203 Consult 99213 Follow Up Visit 95907 & 95913 Nerve Conduction Studies (NCS) 95860 EMG (one limb) 95861 EMG (two limbs) 95863 EMG (three limbs) 95864 EMG (four limbs) 95885-95887 EMG with NCS 95816-95819 EEG 96116 Neurobehavioral Status Exam PULMONOLOGY 99203 Consult 99213 Follow Up Visit 94375, 94010, 94060, 94200, 94760, 94726, 94727, 94728, 94729 PFT (Pulmonary Function Tests) 94762 Pulse Oximetry 95810 & 95811 Sleep Study 31622 Diagnostic Bronchoscopy 31628-31629 Bronchoscopy with Biopsy ONCOLOGY/HEMATOLOGY 99203 Consult 99213 Follow Up Visit 36430 Blood Transfusion 99195 Phlebotomy 38221 Bone Marrow Biopsy RADIOLOGY ONCOLOGY 99203 Consult 99213 Follow Up Visit RADIOLOGY 74170 CT Scan Abdomen w/ & w/out contrast 74150 CT Scan Abdomen w/out Contrast 74160 CT Scan Abdomen w/ contrast 72194 CT Scan Pelvis w/ & w/out contrast 72192 CT Scan Pelvis w/out contrast 72193 CT Scan Pelvis w/ contrast 74177 CT Scan Abdomen & Pelvis w/ contrast 74176 CT Scan Abdomen & Pelvis w/o contrast 74178 CT Scan Abdomen & Pelvis w/ & w/o contrast 71270 CT Scan Chest w/ & w/o contrast 71250 CT Scan Chest w/out contrast 71260 CT Scan Chest w/ contrast 70486 CT Scan Sinuses w/out contrast 70470 CT Scan Head/Brain w/ & w/out contrast 70460 CT Scan Head/Brain w/ contrast 70450 CT Scan Head/Brain w/out contrast 70551 MRI Brain w/out contrast 70552 MRI Brain w/ contrast 70553 MRI Brain w/ & w/out contrast 72148 MRI Lumbar Spine w/out contrast 72141 MRI Cervical Spine w/out contrast OPHTHALMOLOGY 99203 Consult 99213 Follow Up Visit 92014 Eye Exam & Treatment 92015 Eye Refraction Exam 92081-92083 Visual Fields 66984 Cataract Extraction with Lens Prosthesis 66821 Cataract YAG Laser PAIN MANAGEMENT 99203 Consult 99213 Follow Up Visit 62282 Epidural Injection (Lumbar) 20550-20553 Trigger Point Injections 27096 Sacro-iliac (SI) Joint Injection 20600-20610 Major Joint Injection PHYSICAL MEDICINE & REHAB 99203 Consult 99213 Follow Up Visit 20550-20553 Trigger Point Injection 20600-20610 Joint Injection 06/25/2017 -2- 72146 MRI Thoracic Spine w/out contrast 74181 MRI Abdomen w/out contrast 72195 MRI Pelvis w/out contrast 73221 MRI Upper Extremity Joint 73721 MRI Lower Extremity Joint 78813 PET Scan Whole Body 77080 DEXA Scan 93880 Carotid Doppler 93922 Limited ABI 93923 Complete ABI 93925 Bilateral Lower Extremity Arterial Duplex Scan 93930 Bilateral Upper Extremity Arterial Duplex Scan 93970 Bilateral Extremity Venous Duplex Scan 19083-19084 Breast Biopsy with Ultrasound Guidance 19081-19082 Stereotactic Breast Biopsy 78306 Whole Body Bone Scan 78315 3 Phase Bone Scan 78580 Lung Perfusion Image 74455 VCUG 78226-78227 HIDA Scan 76770 Renal Scan 78012 Thyroid Uptake 78013 Thyroid Imaging 78014 Thyroid Imaging w/ Uptake REHABILITATION THERAPY 97001 Physical Therapy Eval 97110 Physical Therapy Visits 92521-92524 Speech Therapy Eval 92507 Speech Therapy Visits 97003 Occupational Therapy Eval 97110 Occupational Therapy Visits THORACIC SURGERY 99203 Consult 99213 Follow Up Visit UROLOGY 99203 Consult 99213 Follow Up Visit 52000 Cystoscopy 76872 Prostate Ultrasound 81000 Urinalysis 55700 Prostate Biopsy 51741 Uroflow 51725 Simple Cystometrogram 51726 Complex Cystometrogram 51702 Foley Catheter Insertion 52310 Cystoscopy w/ Stent Removal 51798 Post-Voiding Residual 06/25/2017 -3-