2022 OMFS Physician Fee Schedule Changes for CA Workers' Comp

2022 OMFS Physician Fee Schedule Changes for CA Workers' Comp

California’s Division of Workers’ Compensation (DWC) issued an update to the Physician and Non-Physician Practitioner portion of the Official Medical Fee Schedule (OMFS) for workers’ compensation, effective for all dates of service on or after January 1, 2022.  

The update 1) adopts a new California workers’ comp Conversion Factor 2) adds 267 new procedure codes, 3) alters the reimbursement calculation for two procedure codes, and 4) deletes over a hundred existing procedure codes.

The update conforms the OMFS to relevant 2022 changes in the Medicare payment system, as required by California Labor Code Section 5307.1. The DWC announced the update in a recent Newsline, and posted the order adopting the update on the DWC website.

Read on for details!

Make calculating 2022 OMFS reimbursements easy: Try our OMFS Calculator for accurate, instant, always-updated rates (Fee Schedules: California, New York and US DOL).

Increased Conversion Factor

Calculating reimbursement rates for physician services first requires determining the “Base Maximum Fee,” before applying other fee-affecting modifiers or rules. Under the current fee schedule, based on the Centers for Medicare and Medicaid Services’ (CMS) Resource-Based Relative Value Scale (RBRVS), the Base Maximum Fee is calculated using three factors:

  1. Relative Value Units (RVUs) as determined by Medicare
  2. Geographic Practice Cost Index (GPCI) as determined by Medicare
  3. Conversion Factor (CF) as determined by the California DWC.

The DWC update increases the California Conversion Factor for dates of service on or after January 1, 2022 — by 1.3%, from $45.87 to $46.45.

267 New HCPCS Codes

Listed below are the new Healthcare Common Procedure Coding System (HCPCS) codes adopted by the DWC (and CMS) for 2022.

Note that when Medicare fails to assign an HCPCS code a Relative Value Unit (RVU), the reimbursement is calculated “By Report” (BR).

California Code of Regulations Section 9789.12.4 offers guidelines to determine appropriate reimbursement amounts for BR codes; essentially, providers find a comparable procedure in terms of time, skill, and resources required, and charge accordingly. The provider must justify the amount charged with a separate (non-reimbursable) report.

2022 New HCPCS Codes for CA Workers’ Comp Physician Services

HCPCS

Description

Reimbursement

A2001

Innovamatrix ac, per sq cm

By Report

A2002

Mirragen adv wnd mat per sq

By Report

A2004

Xcellistem, per sq cm

By Report

A2005

Microlyte matrix, per sq cm

By Report

A2006

Novosorb synpath per sq cm

By Report

A2007

Restrata, per sq cm

By Report

A2008

Theragenesis, per sq cm

By Report

A2009

Symphony, per sq cm

By Report

A2010

Apis, per square centimeter

By Report

A4436

Irr supply sleev reus per mo

RVU+GPCI+CF

A4437

Irr supply sleev disp per mo

RVU+GPCI+CF

A9595

Piflu f-18, dia 1 millicurie

By Report

D3911

Intraorifice barrier

By Report

D3921

Decor or submerg erupt tooth

By Report

D4322

Splint intra-coronal

By Report

D4323

Splint extra-coronal

By Report

D5227

Immed max part denture

By Report

D5228

Immed mand part denture

By Report

D5725

Rebase hybrid prosthesis

By Report

D5765

Liner compl/partial rem dent

By Report

D6198

Remove interim implant

By Report

D7298

Remove screw retained plate

By Report

D7299

Rem anchorage device w/flap

By Report

D7300

Rem anchorage dev w/o flap

By Report

D9912

Pre-visit patient screening

By Report

D9947

Sleep apnea appliance

By Report

D9948

Adjust sleep apnea appliance

By Report

D9949

Repair sleep apnea appliance

By Report

G0028

Doc med rsn no scr tob

RVU+GPCI+CF

G0029

No tob scr/cess int

RVU+GPCI+CF

G0030

Pt scr tob & cess int

RVU+GPCI+CF

G0031

Pall serv during meas

RVU+GPCI+CF

G0032

2+ antipsy schiz

RVU+GPCI+CF

G0033

2+ benzo seiz

RVU+GPCI+CF

G0034

Pall serv during meas

RVU+GPCI+CF

G0035

Pt ed pos 23

RVU+GPCI+CF

G0036

Pt/ptn decln assess

RVU+GPCI+CF

G0037

Pt not able to participate

RVU+GPCI+CF

G0038

Clin pt no ref

RVU+GPCI+CF

G0039

Pt no ref, rn spec

RVU+GPCI+CF

G0040

Pt phys/occ therapy

RVU+GPCI+CF

G0041

Pt/ptn decln referral

RVU+GPCI+CF

G0042

Ref to therapy

RVU+GPCI+CF

G0043

Pt mech pros ht valv

RVU+GPCI+CF

G0044

Pt mitral stenosis

RVU+GPCI+CF

G0045

Mrs 90 days post stk

RVU+GPCI+CF

G0046

No mrs 90 days post stk

RVU+GPCI+CF

G0047

Ped blunt hd traum

RVU+GPCI+CF

G0048

Pall serv during meas

RVU+GPCI+CF

G0049

Main hemo in-cntr

RVU+GPCI+CF

G0050

Pt w/ lmted life expec

RVU+GPCI+CF

G0051

Pt hospice mnth

RVU+GPCI+CF

G0052

Pt peri dialysis dur mo

RVU+GPCI+CF

G0053

Adv rheum pt care mvp

RVU+GPCI+CF

G0054

Strk cr prev pos outcme mvp

RVU+GPCI+CF

G0055

Adv care heart dx mvp

RVU+GPCI+CF

G0056

Opt chronic dx mang mvp

RVU+GPCI+CF

G0057

Best pct pt safety em mvp

RVU+GPCI+CF

G0058

Imprv care le jnt repr mvp

RVU+GPCI+CF

G0059

Pt sfty pos exp w aneth mvp

RVU+GPCI+CF

G0060

Allergy/immunology ss

RVU+GPCI+CF

G0061

Anesthesiology ss

RVU+GPCI+CF

G0062

Audiology ss

RVU+GPCI+CF

G0063

Cardiology ss

RVU+GPCI+CF

G0064

Cert nurse midwife ss

RVU+GPCI+CF

G0065

Chiropractic ss

RVU+GPCI+CF

G0066

Clinical social work ss

RVU+GPCI+CF

G0067

Dentistry ss

RVU+GPCI+CF

G0465

Autolog prp diab wound ulcer

By Report

G1024

Cdsm radrite

By Report

G1025

Pt mnth 1 mcp prov

RVU+GPCI+CF

G1026

Pt hemo > 3mo

RVU+GPCI+CF

G1027

Pt hemo < 3mo

RVU+GPCI+CF

G1028

Take home supply 8mg per 0.1

RVU+GPCI+CF

G4000

Dermatology ss

RVU+GPCI+CF

G4001

Diagnostic rad ss

RVU+GPCI+CF

G4002

Ep cardio ss

RVU+GPCI+CF

G4003

Emergency med ss

RVU+GPCI+CF

G4004

Endocrinology ss

RVU+GPCI+CF

G4005

Family medicine ss

RVU+GPCI+CF

G4006

Gastroenterology ss

RVU+GPCI+CF

G4007

General surgery ss

RVU+GPCI+CF

G4008

Geriatrics ss

RVU+GPCI+CF

G4009

Hospitalists ss

RVU+GPCI+CF

G4010

Infectious disease ss

RVU+GPCI+CF

G4011

Internal medicine ss

RVU+GPCI+CF

G4012

Interventional rad ss

RVU+GPCI+CF

G4013

Mentl/behav health ss

RVU+GPCI+CF

G4014

Nephrology ss

RVU+GPCI+CF

G4015

Neurology ss

RVU+GPCI+CF

G4016

Neurosurgical ss

RVU+GPCI+CF

G4017

Nutrition/dietician ss

RVU+GPCI+CF

G4018

Ob/gyn ss

RVU+GPCI+CF

G4019

Oncology/hema ss

RVU+GPCI+CF

G4020

Ophthalmology ss

RVU+GPCI+CF

G4021

Orthopedic surgery ss

RVU+GPCI+CF

G4022

Otolaryngology ss

RVU+GPCI+CF

G4023

Pathology ss

RVU+GPCI+CF

G4024

Pediatrics ss

RVU+GPCI+CF

G4025

Physical medicine ss

RVU+GPCI+CF

G4026

Phys/occ therapy ss

RVU+GPCI+CF

G4027

Plastic surgery ss

RVU+GPCI+CF

G4028

Podiatry ss

RVU+GPCI+CF

G4029

Preventive medicine ss

RVU+GPCI+CF

G4030

Pulmonology ss

RVU+GPCI+CF

G4031

Radiation oncology ss

RVU+GPCI+CF

G4032

Rheumatology ss

RVU+GPCI+CF

G4033

Skilled nursing facility ss

RVU+GPCI+CF

G4034

Speech language path ss

RVU+GPCI+CF

G4035

Thoracic surgery ss

RVU+GPCI+CF

G4036

Urgent care ss

RVU+GPCI+CF

G4037

Urology ss

RVU+GPCI+CF

G4038

Vascular surgery ss

RVU+GPCI+CF

G9988

Pall serv during meas

RVU+GPCI+CF

G9989

Med rsn no pneum vax

RVU+GPCI+CF

G9990

No pneum vax admin 60+

RVU+GPCI+CF

G9991

Pneum vax admin 60+

RVU+GPCI+CF

G9992

Pall serv during meas

RVU+GPCI+CF

G9993

Pall serv during meas

RVU+GPCI+CF

G9994

Pall serv during meas

RVU+GPCI+CF

G9995

Pall serv during meas

RVU+GPCI+CF

G9996

Doc pt pal or hospice

RVU+GPCI+CF

G9997

Doc pt preg dur msrmt pd

RVU+GPCI+CF

G9998

Doc med rsn <3 colon

RVU+GPCI+CF

G9999

Doc sys rsn <3 colon

RVU+GPCI+CF

J0172

Inj, aducanumab-avwa, 2 mg

By Report

J1952

Leuprolide inj, camcevi, 1mg

By Report

J2506

Inj pegfilgrast ex bio 0.5mg

By Report

J9021

Inj, aspara, rylaze, 0.1 mg

By Report

J9061

Inj, amivantamab-vmjw

By Report

J9272

Inj, dostarlimab-gxly, 10 mg

By Report

M0240

Casiri and imdev repeat

By Report

M0241

Casiri and imdev repeat hm

By Report

Q0240

Casirivi and imdevi 600 mg

By Report

Q2055

Idecabtagene vicleucel car

By Report

Q4199

Cygnus matrix, per sq cm

By Report

0003A

Adm sarscov2 30mcg/0.3ml 3rd

By Report

0013A

Adm sarscov2 100mcg/0.5ml3rd

By Report

01937

Anes drg/aspir crv/thrc

RVU+GPCI+CF

01938

Anes drg/aspir lmbr/sac

RVU+GPCI+CF

01939

Anes nulyt agt crv/thrc

RVU+GPCI+CF

01940

Anes nulyt agt lmbr/sac

RVU+GPCI+CF

01941

Anes neuromd/ntrvrt crv/thrc

RVU+GPCI+CF

01942

Anes neuromd/ntrvrt lmbr/sac

RVU+GPCI+CF

0671T

Insj ant sgm aq drg dev 1+

By Report

0672T

Ndovag cryg rf remdl tiss

By Report

0673T

Abltj b9 thyr ndul perq lasr

By Report

0674T

Laps insj nw/rpcmt prm isdss

By Report

0675T

Laps insj nw/rpcmt isdss 1ld

By Report

0676T

Laps insj nw/rpcmt isdss ea

By Report

0677T

Laps repos lead isdss 1st ld

By Report

0678T

Laps repos lead isdss ea add

By Report

0679T

Laps rmvl lead isdss

By Report

0680T

Insj/rplcmt pg only isdss

By Report

0681T

Rlcj pulse gen only isdss

By Report

0682T

Removal pulse gen only isdss

By Report

0683T

Prgrmg dev eval isdss ip

By Report

0684T

Peri-px dev eval isdss ip

By Report

0685T

Interrog dev eval isdss ip

By Report

0686T

Histotripsy mal hepatcel tis

By Report

0687T

Tx amblyopia dev setup 1st

By Report

0688T

Tx amblyopia assmt w/report

By Report

0689T

Quan us tis charac w/o dx us

By Report

0690T

Quan us tis charac w/dx us

By Report

0691T

Auto alys xst ct std vrt fx

By Report

0692T

Therapeutic ultrafiltration

By Report

0693T

Compre ful bdy 3d mtn alys

By Report

0694T

3d vol img&rcnstj brst/ax

By Report

0695T

Bdy srf mpg pm/cvdfb tm impl

By Report

0696T

Bdy surf mapg pm/cvdfb f/up

By Report

0697T

Quan mr tis wo mri mlt orgn

By Report

0698T

Quan mr tiss w/mri mlt orgn

By Report

0699T

Njx pst chmbr eye medication

By Report

0700T

Molec fluor img sus nev 1st

By Report

0701T

Molec fluor img sus nev ea

By Report

0702T

Rem ther mntr ol tech sprt

By Report

0703T

Rem ther mntr ol cog bhv

By Report

0704T

Rem tx amblyopia setup&edu

By Report

0705T

Rem tx amblyopia tech sprt

By Report

0706T

Rem tx amblyopia i&r phy/qhp

By Report

0707T

Njx b1 sub mtrl sbchdrl dfct

By Report

0708T

Id ca immntx prep & 1st njx

By Report

0709T

Id ca immntx each addl njx

By Report

0710T

N-invas artl plaq alys

By Report

0711T

N-nvs artl plaq alys dat prp

By Report

0712T

N-nvs artl plaq alys quan

By Report

0713T

N-nvs artl plaq alys rvw i&r

By Report

33267

Excl laa open any method

RVU+GPCI+CF

33268

Excl laa opn oth px any meth

RVU+GPCI+CF

33269

Excl laa thrscp any method

RVU+GPCI+CF

33370

Tcat plmt&rmvl cepd perq

RVU+GPCI+CF

33509

Ndsc hrv uxtr art 1 sgm cab

RVU+GPCI+CF

33894

Evasc st rpr thrc/aa acrs br

RVU+GPCI+CF

33895

Evasc st rpr thrc/aa x crsg

RVU+GPCI+CF

33897

Perq trluml angp nt/recr coa

RVU+GPCI+CF

42975

Dise eval slp do brth flx dx

RVU+GPCI+CF

43497

Transorl lwr esophgl myotomy

RVU+GPCI+CF

53451

Tprnl balo cntnc dev bi

By Report

53452

Tprnl balo cntnc dev uni

By Report

53453

Tprnl balo cntnc dev rmvl ea

By Report

53454

Tprnl balo cntnc dev adjmt

By Report

61736

Litt icr 1 traj 1 smpl les

RVU+GPCI+CF

61737

Litt icr mlt trj mlt/cplx ls

RVU+GPCI+CF

63052

Lam facetc/frmt arthrd lum 1

RVU+GPCI+CF

63053

Lam factc/frmt arthrd lum ea

RVU+GPCI+CF

64582

Opn mpltj hpglsl nstm ary pg

RVU+GPCI+CF

64583

Rev/rplct hpglsl nstm ary pg

RVU+GPCI+CF

64584

Rmvl hpglsl nstim ary pg

RVU+GPCI+CF

64628

Trml dstrj ios bvn 1st 2 l/s

RVU+GPCI+CF

64629

Trml dstrj ios bvn ea addl

RVU+GPCI+CF

66989

Xcpsl ctrc rmvl cplx insj 1+

RVU+GPCI+CF

66991

Xcapsl ctrc rmvl insj 1+

RVU+GPCI+CF

68841

Insj rx elut implt lac canal

RVU+GPCI+CF

69716

Impltj oi implt skl tc esp

RVU+GPCI+CF

69719

Revj/rplcmt oi implt tc esp

RVU+GPCI+CF

69726

Rmvl oi implt skl perq esp

RVU+GPCI+CF

69727

Rmvl oi implt skl tc esp

RVU+GPCI+CF

77089

Tbs dxa cal w/i&r fx risk

RVU+GPCI+CF

77090

Tbs techl prep&transmis data

RVU+GPCI+CF

77091

Tbs techl calculation only

RVU+GPCI+CF

77092

Tbs i&r fx rsk qhp

RVU+GPCI+CF

80220

Drug asy hydroxychloroquine

RVU+GPCI+CF

80503

Path clin consltj sf 5-20

RVU+GPCI+CF

80504

Path clin consltj mod 21-40

RVU+GPCI+CF

80505

Path clin consltj high 41-60

RVU+GPCI+CF

80506

Path clin consltj prolng svc

RVU+GPCI+CF

81349

Cytog alys chrml abnr lw-ps

RVU+GPCI+CF

81523

Onc brst mrna 70 cnt 31 gene

RVU+GPCI+CF

81560

Trnsplj pd lvr&bwl cd154+cll

RVU+GPCI+CF

82653

El-1 fecal quantitative

RVU+GPCI+CF

83521

Ig light chains free each

RVU+GPCI+CF

83529

Asay of interleukin-6 (il-6)

RVU+GPCI+CF

86015

Actin antibody each

RVU+GPCI+CF

86036

Anca screen each antibody

RVU+GPCI+CF

86037

Anca titer each antibody

RVU+GPCI+CF

86051

Aquaporin-4 antb elisa

RVU+GPCI+CF

86052

Aquaporin-4 antb cba each

RVU+GPCI+CF

86053

Aqaprn-4 antb flo cytmtry ea

RVU+GPCI+CF

86231

Ema each ig class

RVU+GPCI+CF

86258

Dgp antibody each ig class

RVU+GPCI+CF

86362

Mog-igg1 antb cba each

RVU+GPCI+CF

86363

Mog-igg1 antb flo cytmtry ea

RVU+GPCI+CF

86364

Tiss trnsgltmnase ea ig clas

RVU+GPCI+CF

86381

Mitochondrial antibody each

RVU+GPCI+CF

86596

Voltage-gtd ca chnl antb ea

RVU+GPCI+CF

87154

Cul typ id bld pthgn 6+ trgt

RVU+GPCI+CF

90759

Hep b vac 3ag 10mcg 3 dos im

By Report

91113

Gi trc img intral colon i&r

RVU+GPCI+CF

93319

3d echo img cgen car anomal

RVU+GPCI+CF

93593

R hrt cath chd nml nt cnj

By Report

93594

R hrt cath chd abnl nt cnj

By Report

93595

L hrt cath chd nm/abn nt cnj

By Report

93596

R&l hrt cath chd nml nt cnj

By Report

93597

R&l hrt cath chd abnl nt cnj

By Report

93598

Car outp meas drg cath chd

By Report

94625

Phy/qhp op pulm rhb w/o mntr

RVU+GPCI+CF

94626

Phy/qhp op pulm rhb w/mntr

RVU+GPCI+CF

98975

Rem ther mntr 1st setup&edu

RVU+GPCI+CF

98976

Rem ther mntr dev sply resp

RVU+GPCI+CF

98977

Rem ther mntr dv sply mscskl

RVU+GPCI+CF

98980

Rem ther mntr 1st 20 min

RVU+GPCI+CF

98981

Rem ther mntr ea addl 20 min

RVU+GPCI+CF

99424

Prin care mgmt phys 1st 30

RVU+GPCI+CF

99425

Prin care mgmt phys ea addl

RVU+GPCI+CF

99426

Prin care mgmt staff 1st 30

RVU+GPCI+CF

99427

Prin care mgmt staff ea addl

RVU+GPCI+CF

99437

Chrnc care mgmt phys ea addl

RVU+GPCI+CF

Reimbursement Calculation Altered

In addition to the above changes, two existing procedure codes formerly billable only “By Report” now have established reimbursement amounts:

  1. CPT 0503T (for procedure “Cor ffr alys gnrj ffr mdl”) and
  2. CPT 92229 (for procedure “Img rta detc/mntr ds poc aly”)

Effective January 1st, Medicare assigned the above-noted codes RVUs. Therefore, the reimbursements are now calculated using the appropriate GPCI assigned to the place of service, and the conversion factor adopted by the DWC.

Deleted Procedure Codes

The update to the Physician Fee Schedule deletes 135 procedure codes. As listed below, these codes are no longer assigned any reimbursement by the DWC.

2022 Deleted HCPCS Codes for CA Workers’ Comp

HCPCS

Description

0191T

Insert ant segment drain int

01935

Anesth perc img dx sp proc

01936

Anesth perc img tx sp proc

0290T

Laser inc for pkp/lkp recip

0355T

Gi tract capsule endoscopy

0356T

Insrt drug device for iop

0376T

Insert ant segment drain int

0423T

Assay secretory type ii pla2

0451T

Insj/rplcmt aortic ventr sys

0452T

Insj/rplcmt dev vasc seal

0453T

Insj/rplcmt mech-elec ntrfce

0454T

Insj/rplcmt subq electrode

0455T

Remvl aortic ventr cmpl sys

0456T

Remvl aortic dev vasc seal

0457T

Remvl mech-elec skin ntrfce

0458T

Remvl subq electrode

0459T

Relocaj rplcmt aortic ventr

0460T

Repos aortic ventr dev eltrd

0461T

Repos aortic contrpulsj dev

0462T

Prgrmg eval aortic ventr sys

0463T

Interrog aortic ventr sys

0466T

Insj ch wal respir eltrd/ra

0467T

Revj/rplmnt ch respir eltrd

0468T

Rmvl ch wal respir eltrd/ra

0548T

Tprnl balo cntnc dev bi

0549T

Tprnl balo cntnc dev uni

0550T

Tprnl balo cntnc dev rmvl ea

0551T

Tprnl balo cntnc dev adjmt

21310

Closed tx nose fx w/o manj

33470

Revision of pulmonary valve

33722

Repair of heart defect

43850

Revise stomach-bowel fusion

43855

Revise stomach-bowel fusion

59135

Treat ectopic pregnancy

63194

Incise spine & cord cervical

63195

Incise spine & cord thoracic

63196

Incise spine&cord 2 trx crvl

63198

Incise spin&cord 2 stgs crvl

63199

Incise spin&cord 2 stgs thrc

69715

Temple bne implnt w/stimulat

69718

Revise temple bone implant

72275

Epidurography

72275

Epidurography

72275

Epidurography

76101

Complex body section x-ray

76101

Complex body section x-ray

76101

Complex body section x-ray

76102

Complex body section x-rays

76102

Complex body section x-rays

76102

Complex body section x-rays

80500

Lab pathology consultation

80502

Lab pathology consultation

92559

Group audiometric testing

92560

Bekesy audiometry screen

92561

Bekesy audiometry diagnosis

92564

Sisi hearing test

93530

Rt heart cath congenital

93530

Rt heart cath congenital

93530

Rt heart cath congenital

93531

R & l heart cath congenital

93531

R & l heart cath congenital

93531

R & l heart cath congenital

93532

R & l heart cath congenital

93532

R & l heart cath congenital

93532

R & l heart cath congenital

93533

R & l heart cath congenital

93533

R & l heart cath congenital

93533

R & l heart cath congenital

93561

Cardiac output measurement

93561

Cardiac output measurement

93561

Cardiac output measurement

93562

Card output measure subsq

93562

Card output measure subsq

93562

Card output measure subsq

95943

Parasymp&symp hrt rate test

95943

Parasymp&symp hrt rate test

95943

Parasymp&symp hrt rate test

A4397

Irrigation supply sleeve

D4320

Provision splnt intracoronal

D4321

Provisional splint extracoro

D8050

Intercep dental tx primary

D8060

Intercep dental tx transitn

D8690

Orthodontic treatment

G0424

Pulmonary rehab w exer

G2064

Md mang high risk dx 30

G2065

Clin mang h risk dx 30

G8422

Pt inelig bmi calculation

G8925

Spir fev1/fvc>=60% & no copd

G8926

Spiro no perf or doc

G8938

Bmi doc onl fup nt doc

G9267

Doc comp or mort w in 30d

G9268

Doc comp or mort w in 90d

G9269

Doc no comp or mort w in 30d

G9270

Doc no comp or mort w in 90d

G9348

Doc rsn for ord ct scan

G9349

Ct within 28 days

G9350

No doc sinus ct 28d or dx

G9399

Doc disc tx choices

G9400

Doc reas no disc tx opt

G9401

No disc tx choices

G9448

Born 1945-1965

G9449

Hx bld transf b/f 1992

G9450

Hx injec drug use

G9561

Presc opiates >6 wks

G9562

Foll-up eval q3mo opiod tx

G9563

No f/u eval q3mo opiod tx

G9577

Presc opiates >6 wks

G9578

Doc opioid tx 1x during ther

G9579

No doc opioid tx 1x at ther

G9583

Presc opiates >6 wks

G9584

Eval opioid use instr/pt int

G9585

No eval opi use instr/intv

G9634

Qual life tool 2x same/impr

G9635

No doc rsn do qual life assm

G9636

No life asst 2x same/decr

G9639

Amp no reqd in48h ieler proc

G9640

Doc plan hybrid/stage proc

G9641

Amp reqd w/in 48h ieler proc

G9647

No mrs score in 90d followup

G9666

Fas/dir ldl 70-189mg/dl mst

G9783

Doc dx dm, fast <70, no stat

J0693

Inj., cefiderocol, 5 mg

J2505

Injection, pegfilgrastim 6mg

J7303

Contraceptive vaginal ring

J7333

Visco-3 inj dose

J7401

Mometasone furoate sinus imp

J9315

Romidepsin injection

M0239

Bamlanivimab-xxxx infusion

M1022

Pt hospice during perf pd

M1025

Pt hospice during perf pd

M1026

Pt hospice during perf pd

M1031

Pt clin ind img hd

Q0239

Bamlanivimab-xxxx

Q4228

Bionextpatch, per sq cm

Q4236

Carepatch per sq cm


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