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Procedure Code Category
CPT Codes
Procedure Code Descriptions
Code Status
AMP
28805
Amputation, foot; transmetatarsal
No Change
AMP
28810
Amputation, metatarsal, with toe, single
No Change
AMP
28820
Amputation, toe; metatarsophalangeal joint
No Change
CPT CODE
PROCEDURE
PRICE
0
CT LIVER PELVIS w/ & w/o contrast,
0
0
CT UROGRAM w/ & w/o contrast
0
73700
CT LOWER EXTREMITY w/o contrast
0
73701
CT LOWER EXTREMITY w/ contrast
0
73702
CT LOWER EXTREMITY w/ & w/o contrast
0
72131
CT LUMBAR SPINE w/o contrast
0
72132
CT LUMBAR SPINE w/ contrast
0
G0297
CT LUNG SCREENING w/o contrast
0
70486
CT MAXILLOFACIAL w/o contrast
0
70490
CT NECK SOFT TISSUE w/o contrast
0
TEST ID
Test Name
CPT Code
MYEFL
Myelodysplastic Syndrome by Flow Cytometry, Bone Marrow
88184-Flow cytometry; first cell surface, cytoplasmic or nuclear marker x 1 88185-Flow cytometry; additional cell surface, cytoplasmic or nuclear marker (each) x18 88189-Flow Cytometry Interpretation, 16 or More Markers (if appropriate)
2425D
25-Hydroxyvitamin D:24,25-Dihydroxyvitamin D Ratio, Serum
82306 82542
ETGX
Ethyl Glucuronide Confirmation, Chain of Custody, Random, Urine
80307 80321 G0480 (if appropriate)
ETGR
Ethyl Glucuronide Screen with Reflex, Random, Urine
80307
ETGS
Ethyl Glucuronide Screen, Random, Urine
80307
ETGC
Ethyl Glucuronide Confirmation, Random, Urine
80321; G0480 (if appropriate)
NUT1F
NUTM1 (15q14) Rearrangement, FISH, Tissue
88271 x 2, 88291-DNA probe, each (first probe set), Interpretation and report 88271 x 2-DNA probe, each; each additional probe set (if appropriate) 88271 x 1-DNA probe, each; coverage for sets containing 3 probes (if appropriate) 88271 x 2-DNA probe, each; coverage for sets containing 4 probes (if appropriate)   88271 x 3-DNA probe, each; coverage for sets containing 5 probes (if appropriate) 88274-w/modifier 52-Interphase in situ hybridization,
FGFR2
FGFR2 (10q26.1) Rearrangement, FISH, Tissue
88271x2, 88291 - DNA probe, each (first probe set), Interpretation and report 88271x2 - DNA probe, each; each additional probe set (if appropriate) 88271x1 - DNA probe, each; coverage for sets containing 3 probes (if appropriate) 88271x2 - DNA probe, each; coverage for sets containing 4 probes (if appropriate) 88271x3 - DNA probe, each; coverage for sets containing 5 probes (if appropriate) 88274 w/modifier 52 - Interphase in situ hybridization,
ETV6F
ETV6 (12p13.2) Rearrangement, FISH, Tissue
88271x2, 88291 - DNA probe, each (first probe set), Interpretation and report 88271x2 - DNA probe, each; each additional probe set (if appropriate) 88271x1 - DNA probe, each; coverage for sets containing 3 probes (if appropriate) 88271x2 - DNA probe, each; coverage for sets containing 4 probes (if appropriate)   88271x3 - DNA probe, each; coverage for sets containing 5 probes (if appropriate) 88274 w/modifier 52 - Interphase in situ hybridization,
HSVC
Herpes Simplex Virus (HSV), Molecular Detection, PCR, Spinal Fluid
87529 x 2 87529 (if appropriate for government payers)
INFXR
Infliximab Quantitation with Reflex to Antibodies to Infliximab, Serum
80230 82397-(if appropriate)
_ML15
Metaphases, <15 (Bill Only)
88267 w/ modifier 52
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