Medical coding glossaries

Drive down coding related denials

New updated 2022 codes for Cardiology that has the most errors

HCPCS Code Short Description Non-Facility Price Facility Price Non-Facility Limiting Charge Facility Limiting Charge Conv Fact
33249 Insj/rplcmt defib w/lead(s) NA $879.18 NA $960.51 32.7442
93306 Tte w/doppler complete $192.86 NA $210.70 NA 32.7442
93458 L hrt artery/ventricle angio $1,007.21 NA $1,100.38 NA 32.7442
93566 Njx car cth slctv rv/ra ang $24.89 $24.89 $27.19 $27.19 32.7442
93653 Compre ep eval tx svt NA $799.61 NA $873.58 32.7442
93000 Electrocardiogram complete $14.08 NA $15.38 NA 32.7442
93010 Electrocardiogram report $7.86 $7.86 $8.59 $8.59 32.7442
93224 Ecg monit/reprt up to 48 hrs $70.73 NA $77.27 NA 32.7442
93272 Ecg/review interpret only $23.25 $23.25 $25.40 $25.40 32.7442
93272 Ecg/review interpret only $23.25 $23.25 $25.40 $25.40 32.7442
Source: CMS Physician Fee Schedule Search

Preventing mistakes on Anatomical anesthesia coding

S.no CPT code Anatomical Area
1 00100-00222 Head
2 00300-00352 Neck
3 00400-00474 Thorax (chest wall and shoulder girdle)
4 00500-00580 Intrathoracic
5 00600-00670 Spine and Spinal Cord
6 00700-00797 Upper Abdomen
7 00800-00882 Lower Abdomen
8 00902-00952 Perineum
9 01112-01173 Pelvis (except hip)
10 01200-01274 Upper Leg (except knee)
11 01320-01444 Knee and Popliteal Area
12 01462-01522 Lower Leg (below knee, including ankle and foot)
13 01610-01680 Shoulder and Axilla
14 01710-01782 Upper Arm and Elbow
15 01810-01860 Forearm, Wrist and Hand
16 01916-01942 Radiological Procedure
17 01951-01953 Burn Excisions or Debridement
18 01958-01969 Obstetric
19 01990-01999 Other Procedure

Internal medicine codes

HCPCS Code Short Description Non-Facility Price Facility Price Non-Facility Limiting Charge Facility Limiting Charge Conv Fact
99211 Off/op est may x req phy/qhp $22.92 $8.51 $25.04 $9.30 32.7442
99212 Office o/p est sf 10 min $55.67 $34.38 $60.81 $37.56 32.7442
99213 Office o/p est low 20 min $89.39 $64.18 $97.66 $70.11 32.7442
99214 Office o/p est mod 30 min $126.07 $94.63 $137.73 $103.38 32.7442
99215 Office o/p est hi 40 min $177.47 $140.47 $193.89 $153.47 32.7442
99231 Sbsq hosp ip/obs sf/low 25 NA $48.13 NA $52.59 32.7442
99232 Sbsq hosp ip/obs moderate 35 NA $76.62 NA $83.71 32.7442
99233 Sbsq hosp ip/obs high 50 NA $115.26 NA $125.92 32.7442
99238 Hosp ip/obs dschrg mgmt 30 NA $78.91 NA $86.21 32.7442
99239 Hosp ip/obs dschrg mgmt >30 NA $111.33 NA $121.63 32.7442

Urgent care codes

HCPCS Code Short Description Non-Facility Price Facility Price Non-Facility Limiting Charge Facility Limiting Charge Conv Fact
99281 Emr dpt vst mayx req phy/qhp NA $11.13 NA $12.16 32.7442
99282 Emergency dept visit sf mdm NA $40.60 NA $44.36 32.7442
99283 Emergency dept visit low mdm NA $69.09 NA $75.48 32.7442
99284 Emergency dept visit mod mdm NA $117.55 NA $128.43 32.7442
99285 Emergency dept visit hi mdm NA $170.27 NA $186.02 32.7442
93005 Electrocardiogram tracing $6.22 NA $6.80 NA 32.7442
99211 Off/op est may x req phy/qhp $22.92 $8.51 $25.04 $9.30 32.7442
20610 Drain/inj joint/bursa w/o us $64.18 $44.53 $70.11 $48.65 32.7442
10120 Inc&rmvl fb subq tiss smpl $150.30 $104.45 $164.20 $114.12 32.7442
97597 Dbrdmt opn wnd 1st 20 cm/< $99.22 $34.38 $108.39 $37.56 32.7442
Source: CMS Physician Fee Schedule Search

Oncology Codes

HCPCS Code Short Description Non-Facility Price Facility Price Non-Facility Limiting Charge Facility Limiting Charge Conv Fact
77427 Radiation tx management x5 $186.64 $186.64 $203.91 $203.91 32.7442
77295 3-d radiotherapy plan $472.17 NA $515.85 NA 32.7442
77301 Radiotherapy dose plan imrt $1,812.72 NA $1,980.40 NA 32.7442
99205 Office o/p new hi 60 min $216.77 $176.82 $236.82 $193.17 32.7442
99215 Office o/p est hi 40 min $177.47 $140.47 $193.89 $153.47 32.7442
96413 Chemo iv infusion 1 hr $127.05 NA $138.80 NA 32.7442
96523 Irrig drug delivery device $24.56 NA $26.83 NA 32.7442
96450 Chemotherapy into cns $158.81 $74.00 $173.50 $80.85 32.7442
77435 Sbrt management $627.38 $627.38 $685.41 $685.41 32.7442
77373 Sbrt delivery $977.41 NA $1,067.83 NA 32.7442

Podiatry codes

HCPCS Code Short Description Non-Facility Price Facility Price Non-Facility Limiting Charge Facility Limiting Charge Conv Fact
99201-99205 Office o/p new sf 15 min - Office o/p new hi 60 min $71.06 - $216.77 $46.17 - $176.82 $77.63 - $236.82 $50.44 - $193.17 32.7442
99211 - 99215 Off/op est may x req phy/qhp - Office o/p est hi 40 min $22.92 - $177.47 $8.51- $140.47 $25.04 - $193.89 $9.30 - $153.47 32.7442
11720 - 11721 Debride nail 1-5 - Debride nail 6 or more $32.42 - $43.88 $13.75 - $22.92 $35.42 - $47.94 $15.03 - $25.04 32.7442
G0127 Trim nail(s) $23.58 $7.20 $25.76 $7.87 32.7442
11055 - 11057 Paring/cutg b9 hyprker les 1 - Parng/cutg b9 hyprkr les >4 $70.07 - $88.74 $15.06 - $27.83 $76.55 - $96.95 $16.46 - $30.41 32.7442
11730 Removal of nail plate $113.30 $52.39 $123.78 $57.24 32.7442
11740 Drain blood from under nail $56.98 $31.76 $62.25 $34.70 32.7442
11750 Removal of nail bed $158.48 $100.20 $173.14 $109.47 32.7442
28308 Incision of metatarsal $562.87 $385.73 $614.94 $421.41 32.7442
29540 Strapping of ankle and/or ft $27.51 $16.70 $30.05 $18.24 32.7442
Source: CMS Physician Fee Schedule Search

Mental Health

HCPCS Code Short Description Non-Facility Price Facility Price Non-Facility Limiting Charge Facility Limiting Charge Conv Fact
90791 Psych diagnostic evaluation $169.29 $145.06 $184.95 $158.48 32.7442
90834 Psytx w pt 45 minutes $101.51 $88.74 $110.90 $96.95 32.7442
90837 Psytx w pt 60 minutes $149.64 $130.98 $163.48 $143.09 32.7442
90847 Family psytx w/pt 50 min $100.53 $99.87 $109.82 $109.11 32.7442
96130 Psycl tst eval phys/qhp 1st $117.88 $106.42 $128.78 $116.26 32.7442
90792 Psych diag eval w/med srvcs $190.57 $166.34 $208.20 $181.73 32.7442
90839 Psytx crisis initial 60 min $144.07 $126.72 $157.40 $138.44 32.7442
90853 Group psychotherapy 27.18 $23.58 $29.69 $25.76 32.7442
90840 Psytx crisis ea addl 30 min $71.38 $63.52 $77.99 $69.40 32.7442
90846 Family psytx w/o pt 50 min $95.94 $95.61 $104.82 $104.46 32.7442
Source: CMS Physician Fee Schedule Search

Orthopedic codes

HCPCS Code Short Description Non-Facility Price Facility Price Non-Facility Limiting Charge Facility Limiting Charge Conv Fact
29881 Knee arthroscopy/surgery NA $540.28 NA $590.26 32.7442
29826 Sho arthrs srg decompression NA $167.00 NA $182.44 32.7442
29823 Sho arthrs srg xtnsv dbrdmt NA $590.71 NA $645.35 32.7442
27447 Total knee arthroplasty NA $1,262.94 NA $1,379.77 32.7442
27750 Treatment of tibia fracture $356.26 $330.72 $389.21 $361.31 32.7442
20610 Drain/inj joint/bursa w/o us $64.18 $44.53 $70.11 $48.65 32.7442
20550 Inj tendon sheath/ligament $56.98 $37.98 $62.25 $41.50 32.7442
20605 Drain/inj joint/bursa w/o us $54.36 $36.02 $59.38 $39.35 32.7442
27279 Arthrd si jt perq/min nvas NA $791.10 NA $864.28 32.7442
99213 Office o/p est low 20 min $89.39 $64.18 $97.66 $70.11 32.7442
Source: CMS Physician Fee Schedule Search

OBGYN codes

HCPCS Code Short Description Non-Facility Price Facility Price Non-Facility Limiting Charge Facility Limiting Charge Conv Fact
59400 Obstetrical care NA $2,390.33 NA $2,611.43 32.7442
99213 Office o/p est low 20 min $89.39 $64.18 $97.66 $70.11 32.7442
99214 Office o/p est mod 30 min $126.07 $94.63 $137.73 $103.38 32.7442
76805 Ob us >= 14 wks sngl fetus $133.27 NA $145.60 NA 32.7442
58100 Biopsy of uterus lining $100.20 $61.89 $109.47 $67.61 32.7442
57454 Bx/curett of cervix w/scope $167.00 $131.30 $182.44 $143.45 32.7442
58558 Hysteroscopy biopsy $1,295.03 $226.59 $1,414.82 $247.55 32.7442
76801 Ob us < 14 wks single fetus $115.26 NA $125.92 NA 32.7442
58661 Laparoscopy remove adnexa NA $643.42 NA $702.94 32.7442
58110 Bx done w/colposcopy add-on $49.44 $39.29 $54.02 $42.93 32.7442
Source: CMS Physician Fee Schedule Search

Urology codes

HCPCS Code Short Description Non-Facility Price Facility Price Non-Facility Limiting Charge Facility Limiting Charge Conv Fact
52332 Cystoscopy and treatment $392.60 $150.62 $428.92 $164.56 32.7442
52352 Cystoscopy and treatment $392.60 $150.62 $428.92 $164.56 32.7442
52000 Cystoscopy $235.43 $77.93 $257.21/td> $85.14 32.7442
52601 Prostatectomy (turp) NA $711.53 NA $777.35 32.7442
51798 Us urine capacity measure $11.13 NA $12.16 NA 32.7442
51741 Electro-uroflowmetry first $14.08 NA $15.38 NA 32.7442
52000 Cystoscopy $235.43 $77.93 $257.21 $85.14 32.7442
51798 Us urine capacity measure $11.13 NA $12.16/td> NA 32.7442
54050 Destruction penis lesion(s) $143.09 $105.76 $156.33 $115.55 32.7442/td>
54400 Insert semi-rigid prosthesis NA $522.60 NA $570.94 32.7442/td>

Dermatology codes

HCPCS Code Short Description Non-Facility Price Facility Price Non-Facility Limiting Charge Facility Limiting Charge Conv Fact
11642 Exc f/e/e/n/l mal+mrg 1.1-2 $264.57 $178.46 $289.05 $194.96 32.7442
17000 Destruct premalg lesion $66.80 $54.36 $72.98 $59.38 32.7442
13151 Destruct premalg lesion $66.80 $54.36 $72.98/td> $59.38 32.7442
13151 Cmplx rpr e/n/e/l 1.1-2.5 cm $415.52 $271.12 $453.96 $296.20 32.7442
15777 Acellular derm $208.58 $208.58 $227.87 $227.87 32.7442
99203 Office o/p new low 30 min $109.69 $79.90 $119.84 $87.29 32.7442
99213 Office o/p est low 20 min $89.39 $64.18 $97.66 $70.11 32.7442
17110 Destruct b9 lesion 1-14 $112.31 $67.78 $122.70 $74.05 32.7442
11301 Shave skin lesion 0.6-1.0 cm $119.52 $49.77 $130.57 $54.38/td> 32.7442
11402 Exc tr-ext b9+marg 1.1-2 cm $169.94 $114.28 $185.66 $124.85 32.7442
14040 Tis trnfr f/c/c/m/n/a/g/h/f $750.50 $613.30 $819.92 $670.03 32.7442

Radiology codes

HCPCS Code Short Description Non-Facility Price Facility Price Non-Facility Limiting Charge Facility Limiting Charge Conv Fact
71045 X-ray exam chest 1 view $25.21 NA $27.55 NA 32.7442
71046 X-ray exam chest 2 views $33.07 NA $36.13 NA 32.7442
74177 Ct abd & pelv w/contrast $133.92 NA $146.31 NA 32.7442
76700 Us exam abdom complete $114.28 NA $124.85 NA 32.7442
70450 Ct head/brain w/o dye $106.75 NA $116.62 NA 32.7442
70486 Ct maxillofacial w/o dye $129.01 NA $140.95 NA 32.7442
72170 X-ray exam of pelvis $27.51 NA $30.05 NA 32.7442
73221 Mri joint upr extrem w/o dye $204.98 NA $223.94 NA 32.7442
77067 Scr mammo bi incl cad $125.74 NA $137.37 NA 32.7442
72141 Mri neck spine w/o dye $192.54 NA $210.35 NA 32.7442

Chiropractic codes

HCPCS Code Short Description Non-Facility Price Facility Price Non-Facility Limiting Charge Facility Limiting Charge Conv Fact
98940 Chiropract manj 1-2 regions $26.85 $21.28 $29.33 $23.25 32.7442
97110 Therapeutic exercises $28.82 NA $31.48 NA 32.7442
97140 Manual therapy 1/> regions $26.52 NA $28.98 NA 32.7442
97530 Therapeutic activities $36.02 NA $39.35 NA 32.7442
G0283 Elec stim other than wound $11.46 NA $12.52 NA 32.7442
98941 Chiropract manj 3-4 regions $38.64 $32.74 $42.21 $35.77 32.7442
98942 Chiropractic manj 5 regions $49.77 $43.88 $54.38 $47.94 32.7442
97112 Neuromuscular reeducation $33.07 NA $36.13 NA 32.7442
97116 Gait training therapy $28.82 NA $31.48 NA 32.7442
97760 Orthotic mgmt&traing 1st enc $46.82 NA $51.16 NA 32.7442

Emergency department codes

S.no CPT and HCPCS codes Description
1 CPT 99281Type A: APC 609Type B: APC 626HCPCS: G0380 Initial Assessment No medication or treatments Rx refill only, asymptomatic Note for Work or School Wound recheck Booster or follow up immunization, no acute injury Dressing changes (uncomplicated) Suture removal (uncomplicated) Discussion of Discharge Instructions (Straightforward)
2 CPT 99282 Type A: APC 613Type B: APC 627HCPCS: G0381 Could include interventions from previous levels, plus any of: Tests by ED Staff (Urine dip, stool hemoccult, Accucheck or Dextrostix) Visual Acuity (Snellen) Obtain clean catch urine Apply ace wrap or sling Prep or assist w/ procedures such as: minor laceration repair, I&D of simple abscess, etc. Discussion of Discharge Instructions (Simple)
3 CPT 99283 Type A: APC 614Type B: APC 628HCPCS: G0382 Could include interventions from previous levels, plus any of: Receipt of EMS/Ambulance patient Heparin/saline lock (1) Nebulizer treatment Preparation for lab tests described in CPT (80048-87999 codes)Preparation for EKG Preparation for plain X-rays of only 1 area (hand, shoulder, pelvis, etc.) Prescription medications administered PO Foley catheters; In & Out caths C-Spine precautions Fluorescein stain Emesis/ Incontinence care Prep or assist w/procedures such as: joint aspiration/injection, simple fracture care etc. Mental Health-anxious, simple treatment Routine psych medical clearance Limited social worker intervention Post mortem care Direct Admit via ED Discussion of Discharge Instructions (Moderate Complexity)
4 CPT 99284 Type A: APC 615Type B: APC 629HCPCS: G0383 Could include interventions from previous levels, plus any of: Preparation for 2 diagnostic tests2: (Labs, EKG, X-ray) Prep for plain X-ray (multiple body areas): C-spine & foot, shoulder & pelvis Prep for special imaging study (CT, MRI, Ultrasound,VQ scans) Cardiac Monitoring (2) Nebulizer treatments Port-a-cath venous access Administration and Monitoring of infusions or parenteral medications (IV, IM, IO, SC) NG/PEG Tube Placement/Replacement Multiple reassessments Prep or assist w/procedures such as: eye irrigation with Morgan lens, bladder irrigation with 3-way foley, pelvic exam, etc. Sexual Assault Exam w/ out specimen collection Psychotic patient; not suicidal Discussion of Discharge Instructions (Complex)
5 CPT 99285 Type A: APC 616Type B: APC 630 HCPCS: G0384 Could include interventions from previous levels, plus any of: Requires frequent monitoring of multiple vital signs (ie. 02 sat, BP, cardiac rhythm, respiratory rate) Preparation for ≥ 3 diagnostic tests2: (Labs, EKG, X-ray) Prep for special imaging study (CT, MRI, Ultrasound, VQ scan) combined with multiple tests or parenteral medication or oral or IV contrast. Administration of Blood Transfusion/Blood Products Oxygen via face mask or NRB Multiple Nebulizer Treatments: (3) or more (if nebulizer is continuous, each 20 minute period is considered treatment) Moderate Sedation Prep or assist with procedures such as: central line insertion, gastric lavage, LP, paracentesis,etc. Cooling or heating blanket Extended Social Worker intervention Sexual Assault Exam w/ specimen collection by ED staff Coordination of hospital admission/ transfer or change in living situation or site Physical/Chemical Restraints; Suicide Watch Critical Care less than 30 minutes
6 CPT 99291 Type A: APC 617 Could include interventions from previous levels, plus any or all of: Multiple parenteral medications requiring constant monitoring Provision of any of the following: Major Trauma care/ multiple surgical consultants Chest tube insertion Major burn care Treatment of active chest pain in ACS Administration of IV vasoactive meds (see guidelines) CPR Defibrillation/ Cardioversion Pericardiocentesis Administration of ACLS Drugs in cardiac arrest Therapeutic hypothermia Bi-PAP/ CPAP Endotracheal intubation Cricothyrotomy Ventilator management Arterial line placement Control of major hemorrhage Pacemaker insertion through a Central Line Delivery of baby
7 CPT 99292 As above in additional 30 minute increments. Record the TOTAL critical care time. The first 30-74 minutes equal code 99291. If used, additional 30 minute increments (beyond the first 74 minutes) are coded 99292. Medicare does not pay for code 99292 because it is considered packaged into 99291; however the services should be reported as appropriate.
8 Critical Care with Trauma Team ActivationAPC 618G0390 In addition to 99291, designated trauma centers may report the Trauma Team Activation code G0390 when a trauma team was activated and all other trauma activation criteria are met.

Gastroenterology codes

HCPCS Code Short Description Non-Facility Price Facility Price Non-Facility Limiting Charge Facility Limiting Charge Conv Fact
45380 Colonoscopy and biopsy $425.35 $193.85 $464.69 $211.78 32.7442
43237 Endoscopic us exam esoph NA $188.93 NA $206.41 32.7442
45384 Colonoscopy w/lesion removal $478.72 $220.70 $523.00/td> $241.11 32.7442
43240 Egd w/transmural drain cyst NA $377.87 NA $412.82 32.7442
45382 Colonoscopy w/control bleed $650.30 $249.51 $710.45 $272.59 32.7442
45379 Colonoscopy w/fb removal $426.00 $230.19 $465.41 $251.48 32.7442
43236 Uppr gi scope w/submuc in $393.59 $134.25 $429.99 $146.67 32.7442
45386 Colonoscopy w/balloon dilat $595.94 $204.65 $651.07 $223.58 32.7442
43238 Egd us fine needle bx/aspir NA $223.97 NA $244.69 32.7442
45381 Colonoscopy submucous njx $434.19 $193.52 $474.35 $211.42 32.7442

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