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
description92508 Speech/hearing therapy 92511 Nasopharyngoscopy 92512 Nasal function studies 92516 Facial nerve function test 92520 Laryngeal function studies 92565 Stenger test, pure tone 92571 Filtered speech hearing test 92575 Sensorineural acuity test 92576 Synthetic sentence test 92577 Stenger test, speech 92582 Conditioning play audiometry 93721 Plethysmography tracing 93797 Cardiac rehab 93798 Cardiac rehab/monitor 95010 Sensitivity skin tests 95015 Sensitivity skin tests 95056 Photosensitivity tests 95065 Nose allergy test 95075 Ingestion challenge test 95144 Antigen therapy services 95145 Antigen therapy services 95146 Antigen therapy services 95147 Antigen therapy services 95148 Antigen therapy services 95149 Antigen therapy services 95165 Antigen therapy services 95170 Antigen therapy services 95180 Rapid desensitization 95831 Limb muscle testing, manual 95832 Hand muscle testing, manual 95833 Body muscle testing, manual 95834 Body muscle testing, manual 95851 Range of motion measurements 95852 Range of motion measurements 95857 Tensilon test 96405 Intralesional chemotherapy administration 96406 Intralesional chemotherapy administration 96445 Chemotherapy, intracavitary 96450 Chemotherapy, into central nervous system 96542 Chemotherapy injection 98940 Chiropractor manip of spine 98941 Chiropractor manip of spine 98942 Chiropractor manip of spine 98943 Chiropractor manip extra spinal 99201 Office/outpatient visit, new 99202 Office/outpatient visit, new 99203 Office/outpatient visit, new 99204 Office/outpatient visit, new 99205 Office/outpatient visit, new 99211 Office/outpatient visit, established 99212 Office/outpatient visit, established 99213 Office/outpatient visit, established 99214 Office/outpatient visit, established 99215 Office/outpatient visit, established 99241 Office consultation 99242 Office consultation 99243 Office consultation 99244 Office consultation 99245 Office consultation 99271 Confirmatory consultation 99272 Confirmatory consultation 99273 Confirmatory consultation 99274 Confirmatory consultation 99354 Prolonged service, office 99355 Prolonged service, office M0101 Foot care hygiene Back to rule page | Page two | Page three | Page four
Statutory authority: MS s 175.171; 176.101; 176.135; 176.1351; 176.136; 176.231; 176.83
History: 18 SR 1472; 20 SR 530; 25 SR 1142
Posted: June 11, 2008
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