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Days
BS Description E
ICD
IOS BS
CPT
PACKAGE
Price
Center
0
CPM (CONTINUES PASSIVE MOTION)
760025
50
0
Different Medical Insole
760026
10013
50
0
Electrical Massage
96162-00[1908]
760027
9616200
50
0
Electrical Stimulation
13400-00[1890]
760028
1340000
75
0
Electrotherapy
30195-06[1612]
760029
3019506
60
0
H.K.A.F.O. Orthosis
760030
9609100
8,000.00
0
HEPATITIS B IMMUNOGLOBULIN INFUSION SESSION [ HBIG ] (INCL; DRUG PREP, CONSULT SUPERVISION,ACCOM, IVFLUIDS,SUPPLIES, NURSE
13706-05[1893]
760031
2,600.00
CARE, W/OUT MED)
0
HEPATORRHAPHY [ REPAIR OF LIVER LACERATION ]
30422-00[954]
760032
3,200.00
0
Hydrotherapy
96153-00[1880]
760034
9615300
100
0
IN PATIENT PHYSIOTHERAPY (PARTIAL)
95550-00[1920]
760035
9555000
100
0
Includes an assessment by Rehabilitation Consultant. Twelve
760036
5,400.00
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