Workers' compensation -- HIPAA 835 Health care claim payment/remittance advice
5221.4033 Outpatient limitation for medical/surgical facility fee
Subp. 2b. Procedure codes subject to limitation (table continued ...)
procedure code
description53620 Dilate urethra stricture 53621 Dilate urethra stricture 53660 Dilation of urethra 53661 Dilation of urethra 53670 Insert urinary catheter 54050 Destruction, penis lesion(s) 54055 Destruction, penis lesion(s) 54056 Cryosurgery, penis lesion(s) 54200 Treatment of penis lesion 54230 Prepare penis study 54235 Penile injection 55000 Drainage of hydrocele 55250 Removal of sperm duct(s) 56420 Drainage of gland abscess 56501 Destruction, vulva lesion(s) 56606 Biopsy of vulva/perineum 57061 Destruction, vagina lesion(s) 57100 Biopsy of vagina 57150 Treat vagina infection 57160 Insertion of pessary 57170 Fitting of diaphragm/cap 57452 Examination of vagina 57454 Vagina examination and biopsy 57460 LEEP procedure 57500 Biopsy of cervix 57505 Endocervical curettage 57510 Cauterization of cervix 57511 Cryocautery of cervix 58100 Biopsy of uterus lining 58301 Remove intrauterine device 59200 Insert cervical dilator 59300 Episiotomy or vagional repair 59425 Antepartum care only 59426 Antepartum care only 59430 Care after delivery 60100 Biopsy of thyroid 61001 Remove cranial cavity fluid 63690 Analysis of neuroreceiver 63691 Analysis of neuroreceiver 64400 Injection for nerve block 64405 Injection for nerve block 64408 Injection for nerve block 64412 Injection for nerve block 64413 Injection for nerve block 64418 Injection for nerve block 64435 Injection for nerve block 64440 Injection for nerve block 64441 Injection for nerve block 64445 Injection for nerve block 64450 Injection for nerve block 64505 Injection for nerve block 64508 Injection for nerve block 64550 Apply neurostimulator 64553 Implant neuroelectrodes 64555 Implant neuroelectrodes 64560 Implant neuroelectrodes 64565 Implant neuroelectrodes 64612 Destroy nerve, face muscle 64613 Destroy nerve, spine muscle 65205 Remove foreign body from eye 65210 Remove foreign body from eye 65220 Remove foreign body from eye 65222 Remove foreign body from eye 65286 Repair of eye wound 65430 Corneal smear 65435 Curette/treat cornea 654336 Curette/treat cornea 65600 Revision of cornea 65772 Correction of astigmatism 65855 Laser surgery of eye 65860 Incise inner eye adhesions 66761 Revision of iris 66770 Removal of inner eye lesion 67145 Treatment of retina 67210 Treatment of retinal lesion 67228 Treatment of retinal lesion 67345 Destroy nerve of eye muscle 67505 Inject/treat eye socket 67515 Inject/treat eye socket 67700 Drainage of eyelid abscess 67710 Incision of eyelid 67800 Remove eyelid lesion 67801 Remove eyelid lesions 67805 Remove eyelid lesions 67810 Biopsy of eyelid 67820 Revise eyelashes 67825 Revise eyelashes 67840 Remove eyelid lesion 67850 Treat eyelid lesion 67915 Repair eyelid defect 67922 Repair eyelid defect 67930 Repair eyelid wound 67938 Remove eyelid foreign body 68020 Incise/drain eyelid lining 68040 Treatment of eyelid lesions 68100 Biopsy of eyelid lining 68110 Remove eyelid lining lesion 68135 Remove eyelid lining lesion 68200 Treat eyelid by injection 68400 Incise/drain tear gland 68420 Incise/drain tear sac 68440 Incise tear duct opening 68530 Clearance of tear duct 68705 Revise tear duct opening 68760 Close tear duct opening 68761 Close tear duct opening 68770 Close tear system fistula 68840 Explore/irrigate tear ducts 69000 Drain external ear lesion 69005 Drain external ear lesion 69020 Drain outer ear canal lesion 69100 Biopsy of external ear 69105 Biopsy of external ear canal 69200 Clear outer ear canal 69210 Remove impacted ear wax 69220 Clean out mastoid cavity 69222 Clean out mastoid cavity 69400 Inflate middle ear canal 69401 Inflate middle ear canal 69405 Catheterize middle ear canal 69410 Insert middle ear baffle 69420 Incision of eardrum 69433 Create eardrum opening 69540 Remove ear lesion 69610 Repair of eardrum 92002 Eye exam, new patient 92004 Eye exam, new patient 92012 Eye exam, established patient 92014 Eye exam and treatment 92019 Eye exam and treatment 92020 Special eye evaluation 92070 Fitting of contact lens 92100 Serial tonometry exam(s) 92120 Tonography and eye evaluation 92130 Water provocation tonography 92140 Glaucoma provocative tests 92225 Special eye exam, initial 92226 Special eye exam, subsequent 92230 Eye exam with photos 92260 Ophthalmoscopy/dynamometry 92287 Internal eye photography 92311 Contact lens fitting 92312 Contact lens fitting 92313 Contact lens fitting 92315 Prescription of contact lens 92316 Prescription of contact lens 92317 Prescription of contact lens 92330 Fitting of artificial eye 92335 Fitting of artificial eye 92352 Special spectacles fitting 92353 Special spectacles fitting 92354 Special spectacles fitting 92371 Repair and adjust spectacles 92504 Ear microscopy examination 92506 Speech and hearing evaluation 92507 Speech/hearing therapy Back to rule page | Page two | Page three | Page four (next)
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