2014 practitioners/dme suppliers medically unlikely edits ... · 1. practitioner/dme supplier...
TRANSCRIPT
1
2015 HCPCS: LEVEL II NATIONAL CODES20
15 P
RA
CTIT
ION
ER/D
ME
MU
E
2014 Practitioners/DME Suppliers Medically Unlikely Edits (MUEs)
HCPCS/CPT Code
Practitioner Services
MUE ValuesMUE Adjudication
IndicatorA0382 0 3 Date of Service Edit: Clinical
A0384 0 3 Date of Service Edit: Clinical
A0392 0 3 Date of Service Edit: Clinical
A0394 0 3 Date of Service Edit: Clinical
A0396 0 3 Date of Service Edit: Clinical
A0398 0 3 Date of Service Edit: Clinical
A0420 0 3 Date of Service Edit: Clinical
A0422 0 3 Date of Service Edit: Clinical
A0424 0 3 Date of Service Edit: Clinical
A0426 2 3 Date of Service Edit: Clinical
A0427 2 3 Date of Service Edit: Clinical
A0428 4 3 Date of Service Edit: Clinical
A0429 2 3 Date of Service Edit: Clinical
A0430 1 3 Date of Service Edit: Clinical
A0431 1 3 Date of Service Edit: Clinical
A0432 1 3 Date of Service Edit: Clinical
A0433 1 3 Date of Service Edit: Clinical
A0434 2 3 Date of Service Edit: Clinical
A0435 999 3 Date of Service Edit: Clinical
A0436 300 3 Date of Service Edit: Clinical
A4221 1 1 Line Edit
A4235 2 1 Line Edit
A4253 0 3 Date of Service Edit: Clinical
A4255 0 3 Date of Service Edit: Clinical
A4257 0 3 Date of Service Edit: Clinical
A4258 0 3 Date of Service Edit: Clinical
A4259 0 3 Date of Service Edit: Clinical
A4301 1 2 Date of Service Edit: Policy
A4356 1 1 Line Edit
A4470 1 1 Line Edit
A4480 1 1 Line Edit
A4555 0 3 Date of Service Edit: Clinical
A4557 2 1 Line Edit
HCPCS/CPT Code
Practitioner Services
MUE ValuesMUE Adjudication
IndicatorA4561 1 1 Line Edit
A4562 1 1 Line Edit
A4565 2 3 Date of Service Edit: Clinical
A4606 1 3 Date of Service Edit: Clinical
A4611 0 3 Date of Service Edit: Clinical
A4614 1 1 Line Edit
A4625 30 3 Date of Service Edit: Clinical
A4633 0 3 Date of Service Edit: Clinical
A4635 0 3 Date of Service Edit: Clinical
A4638 0 3 Date of Service Edit: Clinical
A4640 0 3 Date of Service Edit: Clinical
A4642 1 1 Line Edit
A4648 5 3 Date of Service Edit: Clinical
A4650 3 1 Line Edit
A5056 90 3 Date of Service Edit: Clinical
A5057 90 3 Date of Service Edit: Clinical
A5120 150 3 Date of Service Edit: Clinical
A5500 0 3 Date of Service Edit: Clinical
A5501 0 3 Date of Service Edit: Clinical
A5503 0 3 Date of Service Edit: Clinical
A5504 0 3 Date of Service Edit: Clinical
A5505 0 3 Date of Service Edit: Clinical
A5506 0 3 Date of Service Edit: Clinical
A5507 0 3 Date of Service Edit: Clinical
A5508 0 3 Date of Service Edit: Clinical
A5510 0 3 Date of Service Edit: Clinical
A5512 0 3 Date of Service Edit: Clinical
A5513 0 3 Date of Service Edit: Clinical
A6501 2 1 Line Edit
A6502 2 1 Line Edit
A6503 2 1 Line Edit
A6504 4 1 Line Edit
A6505 4 1 Line Edit
Practitioner Edits(Effective Date: 10/01/2014-12/31/2014, Version: 20.3)
This fi le contains two sets of edits that provide guidance when reporting physician/provider services/procedures/supplies/equipment with HCPCS codes.
1. Practitioner/DME Supplier Medically Unlikely Edits (MUEs) units indicate the maximum allowable number of units of service per day, per patient. The third fi eld indicates whether each MUE is a claim line or date of service edit. The purpose of the MUEs project is to detect and deny unlikely Medicare claims on a pre-payment basis in order to stop inappropriate payment. The MUE project is not meant to establish Medicare payment policy, but rather to improve the accuracy of the Medicare payments.
2. Columns 1 and 2 Correct Coding Edits are National Correct Coding Initiative (NCCI) edits for physicians and list codes that are not reported together.
2
PRACTITIONER EDITS2015 PR
ACTITIO
NER
/DM
E MU
E
HCPCS/CPT Code
Practitioner Services
MUE ValuesMUE Adjudication
IndicatorA6506 4 1 Line Edit
A6507 4 1 Line Edit
A6508 4 1 Line Edit
A6509 2 1 Line Edit
A6510 2 1 Line Edit
A6511 2 1 Line Edit
A6513 0 3 Date of Service Edit: Clinical
A6531 0 3 Date of Service Edit: Clinical
A6532 0 3 Date of Service Edit: Clinical
A6545 0 3 Date of Service Edit: Clinical
A7000 0 3 Date of Service Edit: Clinical
A7003 0 3 Date of Service Edit: Clinical
A7005 0 3 Date of Service Edit: Clinical
A7006 0 3 Date of Service Edit: Clinical
A7013 0 3 Date of Service Edit: Clinical
A7014 0 3 Date of Service Edit: Clinical
A7016 0 3 Date of Service Edit: Clinical
A7017 0 3 Date of Service Edit: Clinical
A7020 0 3 Date of Service Edit: Clinical
A7025 0 3 Date of Service Edit: Clinical
A7026 0 3 Date of Service Edit: Clinical
A7027 0 3 Date of Service Edit: Clinical
A7028 0 3 Date of Service Edit: Clinical
A7029 0 3 Date of Service Edit: Clinical
A7032 0 3 Date of Service Edit: Clinical
A7035 0 3 Date of Service Edit: Clinical
A7036 0 3 Date of Service Edit: Clinical
A7037 0 3 Date of Service Edit: Clinical
A7039 0 3 Date of Service Edit: Clinical
A7040 2 1 Line Edit
A7041 2 1 Line Edit
A7042 2 1 Line Edit
A7043 10 3 Date of Service Edit: Clinical
A7044 0 3 Date of Service Edit: Clinical
A7047 0 3 Date of Service Edit: Clinical
A7501 0 3 Date of Service Edit: Clinical
A7504 0 3 Date of Service Edit: Clinical
A7507 0 3 Date of Service Edit: Clinical
A7520 0 3 Date of Service Edit: Clinical
A7524 0 3 Date of Service Edit: Clinical
A7527 0 3 Date of Service Edit: Clinical
A9272 0 1 Line Edit
A9284 0 3 Date of Service Edit: Clinical
A9500 3 1 Line Edit
HCPCS/CPT Code
Practitioner Services
MUE ValuesMUE Adjudication
IndicatorA9501 3 1 Line Edit
A9502 3 1 Line Edit
A9503 1 1 Line Edit
A9504 1 1 Line Edit
A9507 1 1 Line Edit
A9508 2 3 Date of Service Edit: Clinical
A9510 1 1 Line Edit
A9512 30 3 Date of Service Edit: Clinical
A9520 1 3 Date of Service Edit: Clinical
A9521 2 1 Line Edit
A9526 2 1 Line Edit
A9536 1 1 Line Edit
A9537 1 1 Line Edit
A9538 1 1 Line Edit
A9539 2 1 Line Edit
A9540 2 1 Line Edit
A9541 1 1 Line Edit
A9542 1 1 Line Edit
A9543 1 1 Line Edit
A9544 1 1 Line Edit
A9545 1 1 Line Edit
A9546 1 1 Line Edit
A9547 2 3 Date of Service Edit: Clinical
A9550 1 1 Line Edit
A9551 1 1 Line Edit
A9552 1 1 Line Edit
A9553 1 1 Line Edit
A9554 1 1 Line Edit
A9555 3 1 Line Edit
A9556 10 3 Date of Service Edit: Clinical
A9557 2 1 Line Edit
A9559 1 1 Line Edit
A9560 2 1 Line Edit
A9561 1 1 Line Edit
A9562 2 1 Line Edit
A9566 1 1 Line Edit
A9567 2 1 Line Edit
A9569 1 1 Line Edit
A9570 1 1 Line Edit
A9571 1 1 Line Edit
A9579 100 3 Date of Service Edit: Clinical
A9580 1 1 Line Edit
A9582 1 3 Date of Service Edit: Clinical
A9583 18 3 Date of Service Edit: Clinical
3
2015 HCPCS: LEVEL II NATIONAL CODES20
15 P
RA
CTIT
ION
ER/D
ME
MU
E
HCPCS/CPT Code
Practitioner Services
MUE ValuesMUE Adjudication
IndicatorA9584 1 1 Line Edit
A9585 300 3 Date of Service Edit: Clinical
A9586 1 1 Line Edit
A9599 1 3 Date of Service Edit: Clinical
A9600 7 3 Date of Service Edit: Clinical
A9604 1 3 Date of Service Edit: Clinical
A9700 2 1 Line Edit
B4083 0 3 Date of Service Edit: Clinical
B4149 0 3 Date of Service Edit: Clinical
B4153 0 3 Date of Service Edit: Clinical
B4157 0 3 Date of Service Edit: Clinical
B4160 0 3 Date of Service Edit: Clinical
B4164 0 3 Date of Service Edit: Clinical
B4176 0 3 Date of Service Edit: Clinical
B4189 0 3 Date of Service Edit: Clinical
B4199 0 3 Date of Service Edit: Clinical
B5200 0 3 Date of Service Edit: Clinical
C1722 1 3 Date of Service Edit: Clinical
C1749 1 3 Date of Service Edit: Clinical
C1767 2 1 Line Edit
C1772 1 3 Date of Service Edit: Clinical
C1785 1 3 Date of Service Edit: Clinical
C1813 1 3 Date of Service Edit: Clinical
C1820 2 1 Line Edit
C1830 2 1 Line Edit
C1840 1 3 Date of Service Edit: Clinical
C1841 1 3 Date of Service Edit: Clinical
C1886 1 3 Date of Service Edit: Clinical
C2616 1 3 Date of Service Edit: Clinical
C5271 1 2 Date of Service Edit: Policy
C5272 3 2 Date of Service Edit: Policy
C5273 1 2 Date of Service Edit: Policy
C5274 35 3 Date of Service Edit: Clinical
C5275 1 2 Date of Service Edit: Policy
C5276 3 2 Date of Service Edit: Policy
C5277 1 2 Date of Service Edit: Policy
C5278 15 3 Date of Service Edit: Clinical
C9254 0 3 Date of Service Edit: Clinical
C9275 1 3 Date of Service Edit: Clinical
C9285 2 3 Date of Service Edit: Clinical
C9290 266 3 Date of Service Edit: Clinical
C9293 700 3 Date of Service Edit: Clinical
C9352 3 3 Date of Service Edit: Clinical
C9353 4 3 Date of Service Edit: Clinical
HCPCS/CPT Code
Practitioner Services
MUE ValuesMUE Adjudication
IndicatorC9354 300 3 Date of Service Edit: Clinical
C9355 3 3 Date of Service Edit: Clinical
C9356 125 3 Date of Service Edit: Clinical
C9358 800 3 Date of Service Edit: Clinical
C9359 30 3 Date of Service Edit: Clinical
C9360 300 3 Date of Service Edit: Clinical
C9361 10 3 Date of Service Edit: Clinical
C9362 60 3 Date of Service Edit: Clinical
C9363 500 3 Date of Service Edit: Clinical
C9364 600 3 Date of Service Edit: Clinical
C9600 3 3 Date of Service Edit: Clinical
C9601 2 1 Line Edit
C9602 3 3 Date of Service Edit: Clinical
C9603 2 1 Line Edit
C9604 3 1 Line Edit
C9605 3 1 Line Edit
C9606 2 3 Date of Service Edit: Clinical
C9607 1 2 Date of Service Edit: Policy
C9608 2 3 Date of Service Edit: Clinical
C9733 1 1 Line Edit
C9734 1 3 Date of Service Edit: Clinical
C9735 1 2 Date of Service Edit: Policy
C9737 1 2 Date of Service Edit: Policy
C9739 1 2 Date of Service Edit: Policy
C9740 1 2 Date of Service Edit: Policy
E0100 0 3 Date of Service Edit: Clinical
E0105 0 3 Date of Service Edit: Clinical
E0110 0 3 Date of Service Edit: Clinical
E0111 0 3 Date of Service Edit: Clinical
E0112 0 3 Date of Service Edit: Clinical
E0113 0 3 Date of Service Edit: Clinical
E0114 0 3 Date of Service Edit: Clinical
E0116 0 3 Date of Service Edit: Clinical
E0117 0 3 Date of Service Edit: Clinical
E0118 0 3 Date of Service Edit: Clinical
E0130 0 3 Date of Service Edit: Clinical
E0135 0 3 Date of Service Edit: Clinical
E0140 0 3 Date of Service Edit: Clinical
E0141 0 3 Date of Service Edit: Clinical
E0143 0 3 Date of Service Edit: Clinical
E0144 0 3 Date of Service Edit: Clinical
E0147 0 3 Date of Service Edit: Clinical
E0148 0 3 Date of Service Edit: Clinical
E0149 0 3 Date of Service Edit: Clinical
4
PRACTITIONER EDITS2015 PR
ACTITIO
NER
/DM
E MU
E
HCPCS/CPT Code
Practitioner Services
MUE ValuesMUE Adjudication
IndicatorE0153 0 3 Date of Service Edit: Clinical
E0154 0 3 Date of Service Edit: Clinical
E0155 0 3 Date of Service Edit: Clinical
E0156 0 3 Date of Service Edit: Clinical
E0157 0 3 Date of Service Edit: Clinical
E0158 0 3 Date of Service Edit: Clinical
E0159 2 2 Date of Service Edit: Policy
E0160 0 3 Date of Service Edit: Clinical
E0161 0 3 Date of Service Edit: Clinical
E0162 0 3 Date of Service Edit: Clinical
E0163 0 3 Date of Service Edit: Clinical
E0165 0 3 Date of Service Edit: Clinical
E0167 0 3 Date of Service Edit: Clinical
E0168 0 3 Date of Service Edit: Clinical
E0170 0 3 Date of Service Edit: Clinical
E0171 0 3 Date of Service Edit: Clinical
E0172 0 3 Date of Service Edit: Clinical
E0175 0 3 Date of Service Edit: Clinical
E0181 0 3 Date of Service Edit: Clinical
E0182 0 3 Date of Service Edit: Clinical
E0184 0 3 Date of Service Edit: Clinical
E0185 0 3 Date of Service Edit: Clinical
E0186 0 3 Date of Service Edit: Clinical
E0187 0 3 Date of Service Edit: Clinical
E0188 0 3 Date of Service Edit: Clinical
E0189 0 3 Date of Service Edit: Clinical
E0190 0 3 Date of Service Edit: Clinical
E0191 0 3 Date of Service Edit: Clinical
E0193 0 3 Date of Service Edit: Clinical
E0194 0 3 Date of Service Edit: Clinical
E0196 0 3 Date of Service Edit: Clinical
E0197 0 3 Date of Service Edit: Clinical
E0198 0 3 Date of Service Edit: Clinical
E0199 0 3 Date of Service Edit: Clinical
E0200 0 3 Date of Service Edit: Clinical
E0202 0 3 Date of Service Edit: Clinical
E0203 0 3 Date of Service Edit: Clinical
E0205 0 3 Date of Service Edit: Clinical
E0210 0 3 Date of Service Edit: Clinical
E0215 0 3 Date of Service Edit: Clinical
E0217 0 3 Date of Service Edit: Clinical
E0218 0 3 Date of Service Edit: Clinical
E0221 0 3 Date of Service Edit: Clinical
E0225 0 3 Date of Service Edit: Clinical
HCPCS/CPT Code
Practitioner Services
MUE ValuesMUE Adjudication
IndicatorE0231 0 3 Date of Service Edit: Clinical
E0232 0 3 Date of Service Edit: Clinical
E0235 0 3 Date of Service Edit: Clinical
E0236 0 3 Date of Service Edit: Clinical
E0239 0 3 Date of Service Edit: Clinical
E0240 0 3 Date of Service Edit: Clinical
E0241 0 3 Date of Service Edit: Clinical
E0242 0 3 Date of Service Edit: Clinical
E0243 0 3 Date of Service Edit: Clinical
E0244 0 3 Date of Service Edit: Clinical
E0245 0 3 Date of Service Edit: Clinical
E0246 0 3 Date of Service Edit: Clinical
E0247 0 3 Date of Service Edit: Clinical
E0248 0 3 Date of Service Edit: Clinical
E0249 0 3 Date of Service Edit: Clinical
E0250 0 3 Date of Service Edit: Clinical
E0251 0 3 Date of Service Edit: Clinical
E0255 0 3 Date of Service Edit: Clinical
E0256 0 3 Date of Service Edit: Clinical
E0260 0 3 Date of Service Edit: Clinical
E0261 0 3 Date of Service Edit: Clinical
E0265 0 3 Date of Service Edit: Clinical
E0266 0 3 Date of Service Edit: Clinical
E0270 0 3 Date of Service Edit: Clinical
E0271 0 3 Date of Service Edit: Clinical
E0272 0 3 Date of Service Edit: Clinical
E0273 0 3 Date of Service Edit: Clinical
E0274 0 3 Date of Service Edit: Clinical
E0275 0 3 Date of Service Edit: Clinical
E0276 0 3 Date of Service Edit: Clinical
E0277 0 3 Date of Service Edit: Clinical
E0280 0 3 Date of Service Edit: Clinical
E0290 0 3 Date of Service Edit: Clinical
E0291 0 3 Date of Service Edit: Clinical
E0292 0 3 Date of Service Edit: Clinical
E0293 0 3 Date of Service Edit: Clinical
E0294 0 3 Date of Service Edit: Clinical
E0295 0 3 Date of Service Edit: Clinical
E0296 0 3 Date of Service Edit: Clinical
E0297 0 3 Date of Service Edit: Clinical
E0300 0 3 Date of Service Edit: Clinical
E0301 0 3 Date of Service Edit: Clinical
E0302 0 3 Date of Service Edit: Clinical
E0303 0 3 Date of Service Edit: Clinical
5
2015 HCPCS: LEVEL II NATIONAL CODES20
15 P
RA
CTIT
ION
ER/D
ME
MU
E
HCPCS/CPT Code
Practitioner Services
MUE ValuesMUE Adjudication
IndicatorE0304 0 3 Date of Service Edit: Clinical
E0305 0 3 Date of Service Edit: Clinical
E0310 0 3 Date of Service Edit: Clinical
E0315 0 3 Date of Service Edit: Clinical
E0316 0 3 Date of Service Edit: Clinical
E0325 0 3 Date of Service Edit: Clinical
E0326 0 3 Date of Service Edit: Clinical
E0328 0 3 Date of Service Edit: Clinical
E0329 0 3 Date of Service Edit: Clinical
E0350 0 3 Date of Service Edit: Clinical
E0352 0 3 Date of Service Edit: Clinical
E0370 0 3 Date of Service Edit: Clinical
E0371 0 3 Date of Service Edit: Clinical
E0372 0 3 Date of Service Edit: Clinical
E0373 0 3 Date of Service Edit: Clinical
E0424 0 3 Date of Service Edit: Clinical
E0425 0 3 Date of Service Edit: Clinical
E0430 0 3 Date of Service Edit: Clinical
E0431 0 3 Date of Service Edit: Clinical
E0434 0 3 Date of Service Edit: Clinical
E0435 0 3 Date of Service Edit: Clinical
E0439 0 3 Date of Service Edit: Clinical
E0440 0 3 Date of Service Edit: Clinical
E0441 0 3 Date of Service Edit: Clinical
E0442 0 3 Date of Service Edit: Clinical
E0443 0 3 Date of Service Edit: Clinical
E0444 0 3 Date of Service Edit: Clinical
E0445 0 3 Date of Service Edit: Clinical
E0446 0 3 Date of Service Edit: Clinical
E0450 0 3 Date of Service Edit: Clinical
E0455 0 3 Date of Service Edit: Clinical
E0457 0 3 Date of Service Edit: Clinical
E0459 0 3 Date of Service Edit: Clinical
E0460 0 3 Date of Service Edit: Clinical
E0461 0 3 Date of Service Edit: Clinical
E0462 0 3 Date of Service Edit: Clinical
E0463 0 3 Date of Service Edit: Clinical
E0464 0 3 Date of Service Edit: Clinical
E0470 0 3 Date of Service Edit: Clinical
E0471 0 3 Date of Service Edit: Clinical
E0472 0 3 Date of Service Edit: Clinical
E0480 0 3 Date of Service Edit: Clinical
E0481 0 3 Date of Service Edit: Clinical
E0482 0 3 Date of Service Edit: Clinical
HCPCS/CPT Code
Practitioner Services
MUE ValuesMUE Adjudication
IndicatorE0483 0 3 Date of Service Edit: Clinical
E0484 0 3 Date of Service Edit: Clinical
E0485 0 3 Date of Service Edit: Clinical
E0486 0 3 Date of Service Edit: Clinical
E0487 0 3 Date of Service Edit: Clinical
E0500 0 3 Date of Service Edit: Clinical
E0550 0 3 Date of Service Edit: Clinical
E0555 0 3 Date of Service Edit: Clinical
E0560 0 3 Date of Service Edit: Clinical
E0561 0 3 Date of Service Edit: Clinical
E0562 0 3 Date of Service Edit: Clinical
E0565 0 3 Date of Service Edit: Clinical
E0570 0 3 Date of Service Edit: Clinical
E0572 0 3 Date of Service Edit: Clinical
E0574 0 3 Date of Service Edit: Clinical
E0575 0 3 Date of Service Edit: Clinical
E0580 0 3 Date of Service Edit: Clinical
E0585 0 3 Date of Service Edit: Clinical
E0600 0 3 Date of Service Edit: Clinical
E0601 0 3 Date of Service Edit: Clinical
E0602 0 3 Date of Service Edit: Clinical
E0603 0 3 Date of Service Edit: Clinical
E0604 0 3 Date of Service Edit: Clinical
E0605 0 3 Date of Service Edit: Clinical
E0606 0 3 Date of Service Edit: Clinical
E0607 0 3 Date of Service Edit: Clinical
E0610 0 3 Date of Service Edit: Clinical
E0615 0 3 Date of Service Edit: Clinical
E0616 1 2 Date of Service Edit: Policy
E0617 0 3 Date of Service Edit: Clinical
E0618 0 3 Date of Service Edit: Clinical
E0619 0 3 Date of Service Edit: Clinical
E0620 0 3 Date of Service Edit: Clinical
E0621 0 3 Date of Service Edit: Clinical
E0625 0 3 Date of Service Edit: Clinical
E0627 0 3 Date of Service Edit: Clinical
E0628 0 3 Date of Service Edit: Clinical
E0629 0 3 Date of Service Edit: Clinical
E0630 0 3 Date of Service Edit: Clinical
E0635 0 3 Date of Service Edit: Clinical
E0636 0 3 Date of Service Edit: Clinical
E0637 0 3 Date of Service Edit: Clinical
E0638 0 3 Date of Service Edit: Clinical
E0639 0 3 Date of Service Edit: Clinical
6
PRACTITIONER EDITS2015 PR
ACTITIO
NER
/DM
E MU
E
HCPCS/CPT Code
Practitioner Services
MUE ValuesMUE Adjudication
IndicatorE0640 0 3 Date of Service Edit: Clinical
E0641 0 3 Date of Service Edit: Clinical
E0642 0 3 Date of Service Edit: Clinical
E0650 0 3 Date of Service Edit: Clinical
E0651 0 3 Date of Service Edit: Clinical
E0652 0 3 Date of Service Edit: Clinical
E0655 0 3 Date of Service Edit: Clinical
E0656 0 3 Date of Service Edit: Clinical
E0657 0 3 Date of Service Edit: Clinical
E0660 0 3 Date of Service Edit: Clinical
E0665 0 3 Date of Service Edit: Clinical
E0666 0 3 Date of Service Edit: Clinical
E0667 0 3 Date of Service Edit: Clinical
E0668 0 3 Date of Service Edit: Clinical
E0669 0 3 Date of Service Edit: Clinical
E0670 0 3 Date of Service Edit: Clinical
E0671 0 3 Date of Service Edit: Clinical
E0672 0 3 Date of Service Edit: Clinical
E0673 0 3 Date of Service Edit: Clinical
E0675 0 3 Date of Service Edit: Clinical
E0676 1 3 Date of Service Edit: Clinical
E0691 0 3 Date of Service Edit: Clinical
E0692 0 3 Date of Service Edit: Clinical
E0693 0 3 Date of Service Edit: Clinical
E0694 0 3 Date of Service Edit: Clinical
E0700 0 3 Date of Service Edit: Clinical
E0705 0 3 Date of Service Edit: Clinical
E0710 0 3 Date of Service Edit: Clinical
E0720 0 3 Date of Service Edit: Clinical
E0730 0 3 Date of Service Edit: Clinical
E0731 0 3 Date of Service Edit: Clinical
E0740 0 3 Date of Service Edit: Clinical
E0744 0 3 Date of Service Edit: Clinical
E0745 0 3 Date of Service Edit: Clinical
E0746 1 3 Date of Service Edit: Clinical
E0747 0 3 Date of Service Edit: Clinical
E0748 0 3 Date of Service Edit: Clinical
E0749 1 3 Date of Service Edit: Clinical
E0755 0 3 Date of Service Edit: Clinical
E0760 0 3 Date of Service Edit: Clinical
E0761 0 3 Date of Service Edit: Clinical
E0762 0 3 Date of Service Edit: Clinical
E0764 0 3 Date of Service Edit: Clinical
E0765 0 3 Date of Service Edit: Clinical
HCPCS/CPT Code
Practitioner Services
MUE ValuesMUE Adjudication
IndicatorE0766 0 3 Date of Service Edit: Clinical
E0769 0 3 Date of Service Edit: Clinical
E0770 1 3 Date of Service Edit: Clinical
E0776 0 3 Date of Service Edit: Clinical
E0779 0 3 Date of Service Edit: Clinical
E0780 0 3 Date of Service Edit: Clinical
E0781 1 2 Date of Service Edit: Policy
E0782 1 2 Date of Service Edit: Policy
E0783 1 2 Date of Service Edit: Policy
E0784 0 3 Date of Service Edit: Clinical
E0785 1 2 Date of Service Edit: Policy
E0786 1 2 Date of Service Edit: Policy
E0791 0 3 Date of Service Edit: Clinical
E0830 0 3 Date of Service Edit: Clinical
E0840 0 3 Date of Service Edit: Clinical
E0849 0 3 Date of Service Edit: Clinical
E0850 0 3 Date of Service Edit: Clinical
E0855 0 3 Date of Service Edit: Clinical
E0856 0 3 Date of Service Edit: Clinical
E0860 0 3 Date of Service Edit: Clinical
E0870 0 3 Date of Service Edit: Clinical
E0880 0 3 Date of Service Edit: Clinical
E0890 0 3 Date of Service Edit: Clinical
E0900 0 3 Date of Service Edit: Clinical
E0910 0 3 Date of Service Edit: Clinical
E0911 0 3 Date of Service Edit: Clinical
E0912 0 3 Date of Service Edit: Clinical
E0920 0 3 Date of Service Edit: Clinical
E0930 0 3 Date of Service Edit: Clinical
E0935 0 3 Date of Service Edit: Clinical
E0936 0 3 Date of Service Edit: Clinical
E0940 0 3 Date of Service Edit: Clinical
E0941 0 3 Date of Service Edit: Clinical
E0942 0 3 Date of Service Edit: Clinical
E0944 0 3 Date of Service Edit: Clinical
E0945 0 3 Date of Service Edit: Clinical
E0946 0 3 Date of Service Edit: Clinical
E0947 0 3 Date of Service Edit: Clinical
E0948 0 3 Date of Service Edit: Clinical
E0950 0 3 Date of Service Edit: Clinical
E0951 0 3 Date of Service Edit: Clinical
E0952 0 3 Date of Service Edit: Clinical
E0955 0 3 Date of Service Edit: Clinical
E0956 0 3 Date of Service Edit: Clinical
7
2015 HCPCS: LEVEL II NATIONAL CODES20
15 P
RA
CTIT
ION
ER/D
ME
MU
E
HCPCS/CPT Code
Practitioner Services
MUE ValuesMUE Adjudication
IndicatorE0957 0 3 Date of Service Edit: Clinical
E0958 0 3 Date of Service Edit: Clinical
E0959 0 3 Date of Service Edit: Clinical
E0960 0 3 Date of Service Edit: Clinical
E0961 0 3 Date of Service Edit: Clinical
E0966 0 3 Date of Service Edit: Clinical
E0967 0 3 Date of Service Edit: Clinical
E0968 0 3 Date of Service Edit: Clinical
E0970 0 3 Date of Service Edit: Clinical
E0971 0 3 Date of Service Edit: Clinical
E0973 0 3 Date of Service Edit: Clinical
E0974 0 3 Date of Service Edit: Clinical
E0978 0 3 Date of Service Edit: Clinical
E0981 0 3 Date of Service Edit: Clinical
E0982 0 3 Date of Service Edit: Clinical
E0983 0 3 Date of Service Edit: Clinical
E0984 0 3 Date of Service Edit: Clinical
E0985 0 3 Date of Service Edit: Clinical
E0986 0 3 Date of Service Edit: Clinical
E0988 0 3 Date of Service Edit: Clinical
E0990 0 3 Date of Service Edit: Clinical
E0992 0 3 Date of Service Edit: Clinical
E0994 0 3 Date of Service Edit: Clinical
E0995 0 3 Date of Service Edit: Clinical
E1002 0 3 Date of Service Edit: Clinical
E1003 0 3 Date of Service Edit: Clinical
E1004 0 3 Date of Service Edit: Clinical
E1005 0 3 Date of Service Edit: Clinical
E1006 0 3 Date of Service Edit: Clinical
E1007 0 3 Date of Service Edit: Clinical
E1008 0 3 Date of Service Edit: Clinical
E1009 0 3 Date of Service Edit: Clinical
E1010 0 3 Date of Service Edit: Clinical
E1011 0 3 Date of Service Edit: Clinical
E1014 0 3 Date of Service Edit: Clinical
E1015 0 3 Date of Service Edit: Clinical
E1016 0 3 Date of Service Edit: Clinical
E1017 0 3 Date of Service Edit: Clinical
E1018 0 3 Date of Service Edit: Clinical
E1020 0 3 Date of Service Edit: Clinical
E1028 0 3 Date of Service Edit: Clinical
E1029 0 3 Date of Service Edit: Clinical
E1030 0 3 Date of Service Edit: Clinical
E1031 0 3 Date of Service Edit: Clinical
HCPCS/CPT Code
Practitioner Services
MUE ValuesMUE Adjudication
IndicatorE1035 0 3 Date of Service Edit: Clinical
E1037 0 3 Date of Service Edit: Clinical
E1038 0 3 Date of Service Edit: Clinical
E1039 0 3 Date of Service Edit: Clinical
E1050 0 3 Date of Service Edit: Clinical
E1060 0 3 Date of Service Edit: Clinical
E1070 0 3 Date of Service Edit: Clinical
E1083 0 3 Date of Service Edit: Clinical
E1084 0 3 Date of Service Edit: Clinical
E1085 0 3 Date of Service Edit: Clinical
E1086 0 3 Date of Service Edit: Clinical
E1087 0 3 Date of Service Edit: Clinical
E1088 0 3 Date of Service Edit: Clinical
E1089 0 3 Date of Service Edit: Clinical
E1090 0 3 Date of Service Edit: Clinical
E1092 0 3 Date of Service Edit: Clinical
E1093 0 3 Date of Service Edit: Clinical
E1100 0 3 Date of Service Edit: Clinical
E1110 0 3 Date of Service Edit: Clinical
E1130 0 3 Date of Service Edit: Clinical
E1140 0 3 Date of Service Edit: Clinical
E1150 0 3 Date of Service Edit: Clinical
E1160 0 3 Date of Service Edit: Clinical
E1161 0 3 Date of Service Edit: Clinical
E1170 0 3 Date of Service Edit: Clinical
E1171 0 3 Date of Service Edit: Clinical
E1172 0 3 Date of Service Edit: Clinical
E1180 0 3 Date of Service Edit: Clinical
E1190 0 3 Date of Service Edit: Clinical
E1195 0 3 Date of Service Edit: Clinical
E1200 0 3 Date of Service Edit: Clinical
E1220 0 3 Date of Service Edit: Clinical
E1221 0 3 Date of Service Edit: Clinical
E1222 0 3 Date of Service Edit: Clinical
E1223 0 3 Date of Service Edit: Clinical
E1224 0 3 Date of Service Edit: Clinical
E1225 0 3 Date of Service Edit: Clinical
E1226 0 3 Date of Service Edit: Clinical
E1228 0 3 Date of Service Edit: Clinical
E1229 0 3 Date of Service Edit: Clinical
E1230 0 3 Date of Service Edit: Clinical
E1231 0 3 Date of Service Edit: Clinical
E1232 0 3 Date of Service Edit: Clinical
E1233 0 3 Date of Service Edit: Clinical
8
PRACTITIONER EDITS2015 PR
ACTITIO
NER
/DM
E MU
E
HCPCS/CPT Code
Practitioner Services
MUE ValuesMUE Adjudication
IndicatorE1234 0 3 Date of Service Edit: Clinical
E1235 0 3 Date of Service Edit: Clinical
E1236 0 3 Date of Service Edit: Clinical
E1237 0 3 Date of Service Edit: Clinical
E1238 0 3 Date of Service Edit: Clinical
E1240 0 3 Date of Service Edit: Clinical
E1250 0 3 Date of Service Edit: Clinical
E1260 0 3 Date of Service Edit: Clinical
E1270 0 3 Date of Service Edit: Clinical
E1280 0 3 Date of Service Edit: Clinical
E1285 0 3 Date of Service Edit: Clinical
E1290 0 3 Date of Service Edit: Clinical
E1295 0 3 Date of Service Edit: Clinical
E1300 0 3 Date of Service Edit: Clinical
E1310 0 3 Date of Service Edit: Clinical
E1352 0 3 Date of Service Edit: Clinical
E1353 0 3 Date of Service Edit: Clinical
E1354 0 3 Date of Service Edit: Clinical
E1355 0 3 Date of Service Edit: Clinical
E1356 0 3 Date of Service Edit: Clinical
E1357 0 3 Date of Service Edit: Clinical
E1358 0 3 Date of Service Edit: Clinical
E1372 0 3 Date of Service Edit: Clinical
E1390 0 3 Date of Service Edit: Clinical
E1391 0 3 Date of Service Edit: Clinical
E1392 0 3 Date of Service Edit: Clinical
E1405 0 3 Date of Service Edit: Clinical
E1406 0 3 Date of Service Edit: Clinical
E1500 0 3 Date of Service Edit: Clinical
E1510 0 3 Date of Service Edit: Clinical
E1520 0 3 Date of Service Edit: Clinical
E1530 0 3 Date of Service Edit: Clinical
E1540 0 3 Date of Service Edit: Clinical
E1550 0 3 Date of Service Edit: Clinical
E1560 0 3 Date of Service Edit: Clinical
E1570 0 3 Date of Service Edit: Clinical
E1575 0 3 Date of Service Edit: Clinical
E1580 0 3 Date of Service Edit: Clinical
E1590 0 3 Date of Service Edit: Clinical
E1592 0 3 Date of Service Edit: Clinical
E1594 0 3 Date of Service Edit: Clinical
E1600 0 3 Date of Service Edit: Clinical
E1610 0 3 Date of Service Edit: Clinical
E1615 0 3 Date of Service Edit: Clinical
HCPCS/CPT Code
Practitioner Services
MUE ValuesMUE Adjudication
IndicatorE1620 0 3 Date of Service Edit: Clinical
E1625 0 3 Date of Service Edit: Clinical
E1630 0 3 Date of Service Edit: Clinical
E1632 0 3 Date of Service Edit: Clinical
E1634 0 3 Date of Service Edit: Clinical
E1635 0 3 Date of Service Edit: Clinical
E1636 0 3 Date of Service Edit: Clinical
E1637 0 3 Date of Service Edit: Clinical
E1639 0 3 Date of Service Edit: Clinical
E1700 0 3 Date of Service Edit: Clinical
E1701 0 3 Date of Service Edit: Clinical
E1702 0 3 Date of Service Edit: Clinical
E1800 0 3 Date of Service Edit: Clinical
E1801 0 3 Date of Service Edit: Clinical
E1802 0 3 Date of Service Edit: Clinical
E1805 0 3 Date of Service Edit: Clinical
E1806 0 3 Date of Service Edit: Clinical
E1810 0 3 Date of Service Edit: Clinical
E1811 0 3 Date of Service Edit: Clinical
E1812 0 3 Date of Service Edit: Clinical
E1815 0 3 Date of Service Edit: Clinical
E1816 0 3 Date of Service Edit: Clinical
E1818 0 3 Date of Service Edit: Clinical
E1820 0 3 Date of Service Edit: Clinical
E1821 0 3 Date of Service Edit: Clinical
E1825 0 3 Date of Service Edit: Clinical
E1830 0 3 Date of Service Edit: Clinical
E1831 0 3 Date of Service Edit: Clinical
E1840 0 3 Date of Service Edit: Clinical
E1841 0 3 Date of Service Edit: Clinical
E1902 0 3 Date of Service Edit: Clinical
E2000 0 3 Date of Service Edit: Clinical
E2100 0 3 Date of Service Edit: Clinical
E2101 0 3 Date of Service Edit: Clinical
E2120 0 3 Date of Service Edit: Clinical
E2201 0 3 Date of Service Edit: Clinical
E2202 0 3 Date of Service Edit: Clinical
E2203 0 3 Date of Service Edit: Clinical
E2204 0 3 Date of Service Edit: Clinical
E2205 0 3 Date of Service Edit: Clinical
E2206 0 3 Date of Service Edit: Clinical
E2207 0 3 Date of Service Edit: Clinical
E2208 0 3 Date of Service Edit: Clinical
E2209 0 3 Date of Service Edit: Clinical
9
2015 HCPCS: LEVEL II NATIONAL CODES20
15 P
RA
CTIT
ION
ER/D
ME
MU
E
HCPCS/CPT Code
Practitioner Services
MUE ValuesMUE Adjudication
IndicatorE2210 0 3 Date of Service Edit: Clinical
E2211 0 3 Date of Service Edit: Clinical
E2212 0 3 Date of Service Edit: Clinical
E2213 0 3 Date of Service Edit: Clinical
E2214 0 3 Date of Service Edit: Clinical
E2215 0 3 Date of Service Edit: Clinical
E2216 0 3 Date of Service Edit: Clinical
E2217 0 3 Date of Service Edit: Clinical
E2218 0 3 Date of Service Edit: Clinical
E2219 0 3 Date of Service Edit: Clinical
E2220 0 3 Date of Service Edit: Clinical
E2221 0 3 Date of Service Edit: Clinical
E2222 0 3 Date of Service Edit: Clinical
E2224 0 3 Date of Service Edit: Clinical
E2225 0 3 Date of Service Edit: Clinical
E2226 0 3 Date of Service Edit: Clinical
E2227 0 3 Date of Service Edit: Clinical
E2228 0 3 Date of Service Edit: Clinical
E2231 0 3 Date of Service Edit: Clinical
E2291 1 2 Date of Service Edit: Policy
E2292 1 2 Date of Service Edit: Policy
E2293 1 2 Date of Service Edit: Policy
E2294 1 2 Date of Service Edit: Policy
E2295 0 3 Date of Service Edit: Clinical
E2300 0 3 Date of Service Edit: Clinical
E2301 0 3 Date of Service Edit: Clinical
E2310 0 3 Date of Service Edit: Clinical
E2311 0 3 Date of Service Edit: Clinical
E2312 0 3 Date of Service Edit: Clinical
E2313 0 3 Date of Service Edit: Clinical
E2321 0 3 Date of Service Edit: Clinical
E2322 0 3 Date of Service Edit: Clinical
E2323 0 3 Date of Service Edit: Clinical
E2324 0 3 Date of Service Edit: Clinical
E2325 0 3 Date of Service Edit: Clinical
E2326 0 3 Date of Service Edit: Clinical
E2327 0 3 Date of Service Edit: Clinical
E2328 0 3 Date of Service Edit: Clinical
E2329 0 3 Date of Service Edit: Clinical
E2330 0 3 Date of Service Edit: Clinical
E2331 0 3 Date of Service Edit: Clinical
E2340 0 3 Date of Service Edit: Clinical
E2341 0 3 Date of Service Edit: Clinical
E2342 0 3 Date of Service Edit: Clinical
HCPCS/CPT Code
Practitioner Services
MUE ValuesMUE Adjudication
IndicatorE2343 0 3 Date of Service Edit: Clinical
E2351 0 3 Date of Service Edit: Clinical
E2358 0 3 Date of Service Edit: Clinical
E2359 0 3 Date of Service Edit: Clinical
E2361 0 3 Date of Service Edit: Clinical
E2363 0 3 Date of Service Edit: Clinical
E2365 0 3 Date of Service Edit: Clinical
E2366 0 3 Date of Service Edit: Clinical
E2367 0 3 Date of Service Edit: Clinical
E2368 0 3 Date of Service Edit: Clinical
E2369 0 3 Date of Service Edit: Clinical
E2370 0 3 Date of Service Edit: Clinical
E2371 0 3 Date of Service Edit: Clinical
E2373 0 3 Date of Service Edit: Clinical
E2374 0 3 Date of Service Edit: Clinical
E2375 0 3 Date of Service Edit: Clinical
E2376 0 3 Date of Service Edit: Clinical
E2377 0 3 Date of Service Edit: Clinical
E2378 0 3 Date of Service Edit: Clinical
E2381 0 3 Date of Service Edit: Clinical
E2382 0 3 Date of Service Edit: Clinical
E2383 0 3 Date of Service Edit: Clinical
E2384 0 3 Date of Service Edit: Clinical
E2385 0 3 Date of Service Edit: Clinical
E2386 0 3 Date of Service Edit: Clinical
E2387 0 3 Date of Service Edit: Clinical
E2388 0 3 Date of Service Edit: Clinical
E2389 0 3 Date of Service Edit: Clinical
E2390 0 3 Date of Service Edit: Clinical
E2391 0 3 Date of Service Edit: Clinical
E2392 0 3 Date of Service Edit: Clinical
E2394 0 3 Date of Service Edit: Clinical
E2395 0 3 Date of Service Edit: Clinical
E2396 0 3 Date of Service Edit: Clinical
E2397 0 3 Date of Service Edit: Clinical
E2402 0 3 Date of Service Edit: Clinical
E2500 0 3 Date of Service Edit: Clinical
E2502 0 3 Date of Service Edit: Clinical
E2504 0 3 Date of Service Edit: Clinical
E2506 0 3 Date of Service Edit: Clinical
E2508 0 3 Date of Service Edit: Clinical
E2510 0 3 Date of Service Edit: Clinical
E2511 0 3 Date of Service Edit: Clinical
E2512 0 3 Date of Service Edit: Clinical
10
PRACTITIONER EDITS2015 PR
ACTITIO
NER
/DM
E MU
E
HCPCS/CPT Code
Practitioner Services
MUE ValuesMUE Adjudication
IndicatorE2601 0 3 Date of Service Edit: Clinical
E2602 0 3 Date of Service Edit: Clinical
E2603 0 3 Date of Service Edit: Clinical
E2604 0 3 Date of Service Edit: Clinical
E2605 0 3 Date of Service Edit: Clinical
E2606 0 3 Date of Service Edit: Clinical
E2607 0 3 Date of Service Edit: Clinical
E2608 0 3 Date of Service Edit: Clinical
E2609 0 3 Date of Service Edit: Clinical
E2611 0 3 Date of Service Edit: Clinical
E2612 0 3 Date of Service Edit: Clinical
E2613 0 3 Date of Service Edit: Clinical
E2614 0 3 Date of Service Edit: Clinical
E2615 0 3 Date of Service Edit: Clinical
E2616 0 3 Date of Service Edit: Clinical
E2617 0 3 Date of Service Edit: Clinical
E2619 0 3 Date of Service Edit: Clinical
E2620 0 3 Date of Service Edit: Clinical
E2621 0 3 Date of Service Edit: Clinical
E2622 0 3 Date of Service Edit: Clinical
E2623 0 3 Date of Service Edit: Clinical
E2624 0 3 Date of Service Edit: Clinical
E2625 0 3 Date of Service Edit: Clinical
E2626 0 3 Date of Service Edit: Clinical
E2627 0 3 Date of Service Edit: Clinical
E2628 0 3 Date of Service Edit: Clinical
E2629 0 3 Date of Service Edit: Clinical
E2630 0 3 Date of Service Edit: Clinical
E2631 0 3 Date of Service Edit: Clinical
E2632 0 3 Date of Service Edit: Clinical
E2633 0 3 Date of Service Edit: Clinical
G0008 1 2 Date of Service Edit: Policy
G0009 1 2 Date of Service Edit: Policy
G0010 2 1 Line Edit
G0027 1 2 Date of Service Edit: Policy
G0101 1 2 Date of Service Edit: Policy
G0102 1 2 Date of Service Edit: Policy
G0103 1 2 Date of Service Edit: Policy
G0104 1 2 Date of Service Edit: Policy
G0105 1 2 Date of Service Edit: Policy
G0106 1 2 Date of Service Edit: Policy
G0117 1 2 Date of Service Edit: Policy
G0118 1 2 Date of Service Edit: Policy
G0120 1 2 Date of Service Edit: Policy
HCPCS/CPT Code
Practitioner Services
MUE ValuesMUE Adjudication
IndicatorG0121 1 2 Date of Service Edit: Policy
G0123 1 3 Date of Service Edit: Clinical
G0124 1 3 Date of Service Edit: Clinical
G0127 1 2 Date of Service Edit: Policy
G0128 1 1 Line Edit
G0130 1 2 Date of Service Edit: Policy
G0141 1 3 Date of Service Edit: Clinical
G0143 1 3 Date of Service Edit: Clinical
G0144 1 3 Date of Service Edit: Clinical
G0145 1 3 Date of Service Edit: Clinical
G0147 1 3 Date of Service Edit: Clinical
G0148 1 3 Date of Service Edit: Clinical
G0166 2 1 Line Edit
G0168 2 1 Line Edit
G0173 1 2 Date of Service Edit: Policy
G0175 1 3 Date of Service Edit: Clinical
G0177 0 3 Date of Service Edit: Clinical
G0179 1 2 Date of Service Edit: Policy
G0180 1 2 Date of Service Edit: Policy
G0181 1 2 Date of Service Edit: Policy
G0182 1 2 Date of Service Edit: Policy
G0186 1 2 Date of Service Edit: Policy
G0202 1 2 Date of Service Edit: Policy
G0204 2 3 Date of Service Edit: Clinical
G0206 2 3 Date of Service Edit: Clinical
G0235 1 3 Date of Service Edit: Clinical
G0239 1 1 Line Edit
G0245 1 2 Date of Service Edit: Policy
G0246 1 2 Date of Service Edit: Policy
G0247 1 2 Date of Service Edit: Policy
G0248 1 2 Date of Service Edit: Policy
G0249 1 1 Line Edit
G0250 1 2 Date of Service Edit: Policy
G0251 2 3 Date of Service Edit: Clinical
G0259 2 3 Date of Service Edit: Clinical
G0260 2 3 Date of Service Edit: Clinical
G0268 1 2 Date of Service Edit: Policy
G0278 1 2 Date of Service Edit: Policy
G0281 1 1 Line Edit
G0283 1 1 Line Edit
G0288 1 2 Date of Service Edit: Policy
G0289 1 2 Date of Service Edit: Policy
G0293 1 2 Date of Service Edit: Policy
G0294 1 2 Date of Service Edit: Policy
11
2015 HCPCS: LEVEL II NATIONAL CODES20
15 P
RA
CTIT
ION
ER/D
ME
MU
E
HCPCS/CPT Code
Practitioner Services
MUE ValuesMUE Adjudication
IndicatorG0302 1 2 Date of Service Edit: Policy
G0303 1 2 Date of Service Edit: Policy
G0304 1 2 Date of Service Edit: Policy
G0305 1 2 Date of Service Edit: Policy
G0306 2 1 Line Edit
G0307 2 1 Line Edit
G0328 1 2 Date of Service Edit: Policy
G0329 1 1 Line Edit
G0333 0 3 Date of Service Edit: Clinical
G0337 1 2 Date of Service Edit: Policy
G0339 1 2 Date of Service Edit: Policy
G0340 2 3 Date of Service Edit: Clinical
G0341 1 2 Date of Service Edit: Policy
G0342 1 2 Date of Service Edit: Policy
G0343 1 2 Date of Service Edit: Policy
G0364 2 1 Line Edit
G0365 2 1 Line Edit
G0372 1 2 Date of Service Edit: Policy
G0389 1 2 Date of Service Edit: Policy
G0396 1 2 Date of Service Edit: Policy
G0397 1 2 Date of Service Edit: Policy
G0398 1 2 Date of Service Edit: Policy
G0399 1 2 Date of Service Edit: Policy
G0400 1 2 Date of Service Edit: Policy
G0402 1 2 Date of Service Edit: Policy
G0403 1 2 Date of Service Edit: Policy
G0404 1 2 Date of Service Edit: Policy
G0405 1 2 Date of Service Edit: Policy
G0406 1 3 Date of Service Edit: Clinical
G0407 1 3 Date of Service Edit: Clinical
G0408 1 3 Date of Service Edit: Clinical
G0412 1 2 Date of Service Edit: Policy
G0413 1 2 Date of Service Edit: Policy
G0414 1 2 Date of Service Edit: Policy
G0415 1 2 Date of Service Edit: Policy
G0416 1 2 Date of Service Edit: Policy
G0417 1 2 Date of Service Edit: Policy
G0418 1 2 Date of Service Edit: Policy
G0419 1 2 Date of Service Edit: Policy
G0420 2 3 Date of Service Edit: Clinical
G0424 2 2 Date of Service Edit: Policy
G0425 1 3 Date of Service Edit: Clinical
G0426 1 3 Date of Service Edit: Clinical
G0427 1 3 Date of Service Edit: Clinical
HCPCS/CPT Code
Practitioner Services
MUE ValuesMUE Adjudication
IndicatorG0429 1 2 Date of Service Edit: Policy
G0431 1 2 Date of Service Edit: Policy
G0432 1 2 Date of Service Edit: Policy
G0433 1 2 Date of Service Edit: Policy
G0434 1 2 Date of Service Edit: Policy
G0435 1 2 Date of Service Edit: Policy
G0436 1 2 Date of Service Edit: Policy
G0437 1 2 Date of Service Edit: Policy
G0438 1 2 Date of Service Edit: Policy
G0439 1 2 Date of Service Edit: Policy
G0442 1 2 Date of Service Edit: Policy
G0443 1 2 Date of Service Edit: Policy
G0444 1 2 Date of Service Edit: Policy
G0445 1 2 Date of Service Edit: Policy
G0448 1 3 Date of Service Edit: Clinical
G0452 1 1 Line Edit
G0454 1 2 Date of Service Edit: Policy
G0455 1 2 Date of Service Edit: Policy
G0456 1 2 Date of Service Edit: Policy
G0457 1 2 Date of Service Edit: Policy
G0458 1 1 Line Edit
G0459 1 2 Date of Service Edit: Policy
G0460 1 3 Date of Service Edit: Clinical
G0461 9 3 Date of Service Edit: Clinical
G0462 60 3 Date of Service Edit: Clinical
G0463 0 3 Date of Service Edit: Clinical
G3001 1 2 Date of Service Edit: Policy
G9143 1 2 Date of Service Edit: Policy
G9156 1 2 Date of Service Edit: Policy
G9157 1 2 Date of Service Edit: Policy
G9187 1 3 Date of Service Edit: Clinical
J0130 6 3 Date of Service Edit: Clinical
J0131 400 3 Date of Service Edit: Clinical
J0133 1200 3 Date of Service Edit: Clinical
J0135 8 3 Date of Service Edit: Clinical
J0151 180 3 Date of Service Edit: Clinical
J0178 4 3 Date of Service Edit: Clinical
J0210 4 3 Date of Service Edit: Clinical
J0215 30 3 Date of Service Edit: Clinical
J0220 1 3 Date of Service Edit: Clinical
J0221 300 3 Date of Service Edit: Clinical
J0256 3500 3 Date of Service Edit: Clinical
J0257 1400 3 Date of Service Edit: Clinical
J0275 1 3 Date of Service Edit: Clinical
12
PRACTITIONER EDITS2015 PR
ACTITIO
NER
/DM
E MU
E
HCPCS/CPT Code
Practitioner Services
MUE ValuesMUE Adjudication
IndicatorJ0278 15 3 Date of Service Edit: Clinical
J0280 7 3 Date of Service Edit: Clinical
J0289 50 3 Date of Service Edit: Clinical
J0300 8 3 Date of Service Edit: Clinical
J0348 200 3 Date of Service Edit: Clinical
J0350 0 3 Date of Service Edit: Clinical
J0360 2 3 Date of Service Edit: Clinical
J0364 6 3 Date of Service Edit: Clinical
J0456 4 3 Date of Service Edit: Clinical
J0475 8 3 Date of Service Edit: Clinical
J0485 1500 3 Date of Service Edit: Clinical
J0490 160 3 Date of Service Edit: Clinical
J0597 250 3 Date of Service Edit: Clinical
J0638 150 3 Date of Service Edit: Clinical
J0697 4 3 Date of Service Edit: Clinical
J0712 120 3 Date of Service Edit: Clinical
J0717 400 3 Date of Service Edit: Clinical
J0745 2 3 Date of Service Edit: Clinical
J0760 4 3 Date of Service Edit: Clinical
J0770 5 3 Date of Service Edit: Clinical
J0780 4 3 Date of Service Edit: Clinical
J0800 3 3 Date of Service Edit: Clinical
J0833 3 3 Date of Service Edit: Clinical
J0890 0 2 Date of Service Edit: Policy
J0897 120 3 Date of Service Edit: Clinical
J0900 1 3 Date of Service Edit: Clinical
J0945 4 3 Date of Service Edit: Clinical
J1050 1000 3 Date of Service Edit: Clinical
J1162 1 3 Date of Service Edit: Clinical
J1442 3360 3 Date of Service Edit: Clinical
J1446 192 3 Date of Service Edit: Clinical
J1556 300 3 Date of Service Edit: Clinical
J1557 300 3 Date of Service Edit: Clinical
J1561 300 3 Date of Service Edit: Clinical
J1568 300 3 Date of Service Edit: Clinical
J1569 300 3 Date of Service Edit: Clinical
J1572 300 3 Date of Service Edit: Clinical
J1725 250 3 Date of Service Edit: Clinical
J1744 30 3 Date of Service Edit: Clinical
J2212 240 3 Date of Service Edit: Clinical
J2265 400 3 Date of Service Edit: Clinical
J2507 8 3 Date of Service Edit: Clinical
J2995 0 3 Date of Service Edit: Clinical
J3010 100 3 Date of Service Edit: Clinical
HCPCS/CPT Code
Practitioner Services
MUE ValuesMUE Adjudication
IndicatorJ3060 900 3 Date of Service Edit: Clinical
J3285 1 3 Date of Service Edit: Clinical
J3465 40 3 Date of Service Edit: Clinical
J3489 5 3 Date of Service Edit: Clinical
J7196 175 3 Date of Service Edit: Clinical
J7301 0 3 Date of Service Edit: Clinical
J7310 2 2 Date of Service Edit: Policy
J7316 4 2 Date of Service Edit: Policy
J7326 2 2 Date of Service Edit: Policy
J7527 0 3 Date of Service Edit: Clinical
J7604 0 3 Date of Service Edit: Clinical
J7607 0 3 Date of Service Edit: Clinical
J7609 0 3 Date of Service Edit: Clinical
J7610 0 3 Date of Service Edit: Clinical
J7615 0 3 Date of Service Edit: Clinical
J7622 0 3 Date of Service Edit: Clinical
J7624 0 3 Date of Service Edit: Clinical
J7627 0 3 Date of Service Edit: Clinical
J7628 0 3 Date of Service Edit: Clinical
J7629 0 3 Date of Service Edit: Clinical
J7632 0 3 Date of Service Edit: Clinical
J7634 0 3 Date of Service Edit: Clinical
J7635 0 3 Date of Service Edit: Clinical
J7636 0 3 Date of Service Edit: Clinical
J7637 0 3 Date of Service Edit: Clinical
J7638 0 3 Date of Service Edit: Clinical
J7640 0 3 Date of Service Edit: Clinical
J7641 0 3 Date of Service Edit: Clinical
J7642 0 3 Date of Service Edit: Clinical
J7643 0 3 Date of Service Edit: Clinical
J7645 0 3 Date of Service Edit: Clinical
J7647 0 3 Date of Service Edit: Clinical
J7650 0 3 Date of Service Edit: Clinical
J7657 0 3 Date of Service Edit: Clinical
J7660 0 3 Date of Service Edit: Clinical
J7665 127 2 Date of Service Edit: Policy
J7667 0 3 Date of Service Edit: Clinical
J7670 0 3 Date of Service Edit: Clinical
J7676 0 3 Date of Service Edit: Clinical
J7680 0 3 Date of Service Edit: Clinical
J7681 0 3 Date of Service Edit: Clinical
J7683 0 3 Date of Service Edit: Clinical
J7684 0 3 Date of Service Edit: Clinical
J7685 0 3 Date of Service Edit: Clinical
13
2015 HCPCS: LEVEL II NATIONAL CODES20
15 P
RA
CTIT
ION
ER/D
ME
MU
E
HCPCS/CPT Code
Practitioner Services
MUE ValuesMUE Adjudication
IndicatorJ8510 0 3 Date of Service Edit: Clinical
J9019 60 3 Date of Service Edit: Clinical
J9042 200 3 Date of Service Edit: Clinical
J9047 120 3 Date of Service Edit: Clinical
J9179 50 3 Date of Service Edit: Clinical
J9228 450 3 Date of Service Edit: Clinical
J9262 700 3 Date of Service Edit: Clinical
J9306 840 3 Date of Service Edit: Clinical
J9354 600 3 Date of Service Edit: Clinical
J9355 100 3 Date of Service Edit: Clinical
J9400 600 3 Date of Service Edit: Clinical
K0001 0 3 Date of Service Edit: Clinical
K0002 0 3 Date of Service Edit: Clinical
K0003 0 3 Date of Service Edit: Clinical
K0004 0 3 Date of Service Edit: Clinical
K0005 0 3 Date of Service Edit: Clinical
K0006 0 3 Date of Service Edit: Clinical
K0007 0 3 Date of Service Edit: Clinical
K0009 0 3 Date of Service Edit: Clinical
K0015 0 3 Date of Service Edit: Clinical
K0017 0 3 Date of Service Edit: Clinical
K0018 0 3 Date of Service Edit: Clinical
K0019 0 3 Date of Service Edit: Clinical
K0020 0 3 Date of Service Edit: Clinical
K0037 0 3 Date of Service Edit: Clinical
K0038 0 3 Date of Service Edit: Clinical
K0039 0 3 Date of Service Edit: Clinical
K0040 0 3 Date of Service Edit: Clinical
K0041 0 3 Date of Service Edit: Clinical
K0042 0 3 Date of Service Edit: Clinical
K0043 0 3 Date of Service Edit: Clinical
K0044 0 3 Date of Service Edit: Clinical
K0045 0 3 Date of Service Edit: Clinical
K0046 0 3 Date of Service Edit: Clinical
K0047 0 3 Date of Service Edit: Clinical
K0050 0 3 Date of Service Edit: Clinical
K0051 0 3 Date of Service Edit: Clinical
K0052 0 3 Date of Service Edit: Clinical
K0053 0 3 Date of Service Edit: Clinical
K0056 0 3 Date of Service Edit: Clinical
K0065 0 3 Date of Service Edit: Clinical
K0069 0 3 Date of Service Edit: Clinical
K0070 0 3 Date of Service Edit: Clinical
K0071 0 3 Date of Service Edit: Clinical
HCPCS/CPT Code
Practitioner Services
MUE ValuesMUE Adjudication
IndicatorK0072 0 3 Date of Service Edit: Clinical
K0073 0 3 Date of Service Edit: Clinical
K0077 0 3 Date of Service Edit: Clinical
K0105 0 3 Date of Service Edit: Clinical
K0195 0 3 Date of Service Edit: Clinical
K0455 0 3 Date of Service Edit: Clinical
K0462 0 3 Date of Service Edit: Clinical
K0602 0 3 Date of Service Edit: Clinical
K0605 0 3 Date of Service Edit: Clinical
K0606 0 3 Date of Service Edit: Clinical
K0607 0 3 Date of Service Edit: Clinical
K0608 0 3 Date of Service Edit: Clinical
K0609 0 3 Date of Service Edit: Clinical
K0672 0 3 Date of Service Edit: Clinical
K0730 0 3 Date of Service Edit: Clinical
K0733 0 3 Date of Service Edit: Clinical
K0738 0 3 Date of Service Edit: Clinical
K0743 0 3 Date of Service Edit: Clinical
K0744 0 3 Date of Service Edit: Clinical
K0745 0 3 Date of Service Edit: Clinical
K0746 0 3 Date of Service Edit: Clinical
K0800 0 3 Date of Service Edit: Clinical
K0801 0 3 Date of Service Edit: Clinical
K0802 0 3 Date of Service Edit: Clinical
K0806 0 3 Date of Service Edit: Clinical
K0807 0 3 Date of Service Edit: Clinical
K0808 0 3 Date of Service Edit: Clinical
K0812 0 3 Date of Service Edit: Clinical
K0813 0 3 Date of Service Edit: Clinical
K0814 0 3 Date of Service Edit: Clinical
K0815 0 3 Date of Service Edit: Clinical
K0816 0 3 Date of Service Edit: Clinical
K0820 0 3 Date of Service Edit: Clinical
K0821 0 3 Date of Service Edit: Clinical
K0822 0 3 Date of Service Edit: Clinical
K0823 0 3 Date of Service Edit: Clinical
K0824 0 3 Date of Service Edit: Clinical
K0825 0 3 Date of Service Edit: Clinical
K0826 0 3 Date of Service Edit: Clinical
K0827 0 3 Date of Service Edit: Clinical
K0828 0 3 Date of Service Edit: Clinical
K0829 0 3 Date of Service Edit: Clinical
K0830 0 3 Date of Service Edit: Clinical
K0831 0 3 Date of Service Edit: Clinical
14
PRACTITIONER EDITS2015 PR
ACTITIO
NER
/DM
E MU
E
HCPCS/CPT Code
Practitioner Services
MUE ValuesMUE Adjudication
IndicatorK0835 0 3 Date of Service Edit: Clinical
K0836 0 3 Date of Service Edit: Clinical
K0837 0 3 Date of Service Edit: Clinical
K0838 0 3 Date of Service Edit: Clinical
K0839 0 3 Date of Service Edit: Clinical
K0840 0 3 Date of Service Edit: Clinical
K0841 0 3 Date of Service Edit: Clinical
K0842 0 3 Date of Service Edit: Clinical
K0843 0 3 Date of Service Edit: Clinical
K0848 0 3 Date of Service Edit: Clinical
K0849 0 3 Date of Service Edit: Clinical
K0850 0 3 Date of Service Edit: Clinical
K0851 0 3 Date of Service Edit: Clinical
K0852 0 3 Date of Service Edit: Clinical
K0853 0 3 Date of Service Edit: Clinical
K0854 0 3 Date of Service Edit: Clinical
K0855 0 3 Date of Service Edit: Clinical
K0856 0 3 Date of Service Edit: Clinical
K0857 0 3 Date of Service Edit: Clinical
K0858 0 3 Date of Service Edit: Clinical
K0859 0 3 Date of Service Edit: Clinical
K0860 0 3 Date of Service Edit: Clinical
K0861 0 3 Date of Service Edit: Clinical
K0862 0 3 Date of Service Edit: Clinical
K0863 0 3 Date of Service Edit: Clinical
K0864 0 3 Date of Service Edit: Clinical
K0868 0 3 Date of Service Edit: Clinical
K0869 0 3 Date of Service Edit: Clinical
K0870 0 3 Date of Service Edit: Clinical
K0871 0 3 Date of Service Edit: Clinical
K0877 0 3 Date of Service Edit: Clinical
K0878 0 3 Date of Service Edit: Clinical
K0879 0 3 Date of Service Edit: Clinical
K0880 0 3 Date of Service Edit: Clinical
K0884 0 3 Date of Service Edit: Clinical
K0885 0 3 Date of Service Edit: Clinical
K0886 0 3 Date of Service Edit: Clinical
K0890 0 3 Date of Service Edit: Clinical
K0891 0 3 Date of Service Edit: Clinical
K0898 1 2 Date of Service Edit: Policy
K0900 0 3 Date of Service Edit: Clinical
L0112 0 3 Date of Service Edit: Clinical
L0113 0 3 Date of Service Edit: Clinical
L0120 0 3 Date of Service Edit: Clinical
HCPCS/CPT Code
Practitioner Services
MUE ValuesMUE Adjudication
IndicatorL0130 0 3 Date of Service Edit: Clinical
L0140 0 3 Date of Service Edit: Clinical
L0150 0 3 Date of Service Edit: Clinical
L0160 0 3 Date of Service Edit: Clinical
L0170 0 3 Date of Service Edit: Clinical
L0172 0 3 Date of Service Edit: Clinical
L0174 0 3 Date of Service Edit: Clinical
L0180 0 3 Date of Service Edit: Clinical
L0190 0 3 Date of Service Edit: Clinical
L0200 0 3 Date of Service Edit: Clinical
L0220 0 3 Date of Service Edit: Clinical
L0450 0 3 Date of Service Edit: Clinical
L0452 0 3 Date of Service Edit: Clinical
L0454 0 3 Date of Service Edit: Clinical
L0455 0 3 Date of Service Edit: Clinical
L0456 0 3 Date of Service Edit: Clinical
L0457 0 3 Date of Service Edit: Clinical
L0458 0 3 Date of Service Edit: Clinical
L0460 0 3 Date of Service Edit: Clinical
L0462 0 3 Date of Service Edit: Clinical
L0464 0 3 Date of Service Edit: Clinical
L0466 0 3 Date of Service Edit: Clinical
L0467 0 3 Date of Service Edit: Clinical
L0468 0 3 Date of Service Edit: Clinical
L0469 0 3 Date of Service Edit: Clinical
L0470 0 3 Date of Service Edit: Clinical
L0472 0 3 Date of Service Edit: Clinical
L0480 0 3 Date of Service Edit: Clinical
L0482 0 3 Date of Service Edit: Clinical
L0484 0 3 Date of Service Edit: Clinical
L0486 0 3 Date of Service Edit: Clinical
L0488 0 3 Date of Service Edit: Clinical
L0490 0 3 Date of Service Edit: Clinical
L0491 0 3 Date of Service Edit: Clinical
L0492 0 3 Date of Service Edit: Clinical
L0621 0 3 Date of Service Edit: Clinical
L0622 0 3 Date of Service Edit: Clinical
L0623 0 3 Date of Service Edit: Clinical
L0624 0 3 Date of Service Edit: Clinical
L0625 0 3 Date of Service Edit: Clinical
L0626 0 3 Date of Service Edit: Clinical
L0627 0 3 Date of Service Edit: Clinical
L0628 0 3 Date of Service Edit: Clinical
L0629 0 3 Date of Service Edit: Clinical
15
2015 HCPCS: LEVEL II NATIONAL CODES20
15 P
RA
CTIT
ION
ER/D
ME
MU
E
HCPCS/CPT Code
Practitioner Services
MUE ValuesMUE Adjudication
IndicatorL0630 0 3 Date of Service Edit: Clinical
L0631 0 3 Date of Service Edit: Clinical
L0632 0 3 Date of Service Edit: Clinical
L0633 0 3 Date of Service Edit: Clinical
L0634 0 3 Date of Service Edit: Clinical
L0635 0 3 Date of Service Edit: Clinical
L0636 0 3 Date of Service Edit: Clinical
L0637 0 3 Date of Service Edit: Clinical
L0638 0 3 Date of Service Edit: Clinical
L0639 0 3 Date of Service Edit: Clinical
L0640 0 3 Date of Service Edit: Clinical
L0641 0 3 Date of Service Edit: Clinical
L0642 0 3 Date of Service Edit: Clinical
L0643 0 3 Date of Service Edit: Clinical
L0648 0 3 Date of Service Edit: Clinical
L0649 0 3 Date of Service Edit: Clinical
L0650 0 3 Date of Service Edit: Clinical
L0651 0 3 Date of Service Edit: Clinical
L0700 0 3 Date of Service Edit: Clinical
L0710 0 3 Date of Service Edit: Clinical
L0810 0 3 Date of Service Edit: Clinical
L0820 0 3 Date of Service Edit: Clinical
L0830 0 3 Date of Service Edit: Clinical
L0859 0 3 Date of Service Edit: Clinical
L0861 0 3 Date of Service Edit: Clinical
L0970 0 3 Date of Service Edit: Clinical
L0972 0 3 Date of Service Edit: Clinical
L0974 0 3 Date of Service Edit: Clinical
L0976 0 3 Date of Service Edit: Clinical
L0978 0 3 Date of Service Edit: Clinical
L0980 0 3 Date of Service Edit: Clinical
L0982 0 3 Date of Service Edit: Clinical
L0984 0 3 Date of Service Edit: Clinical
L1000 0 3 Date of Service Edit: Clinical
L1001 0 3 Date of Service Edit: Clinical
L1005 0 3 Date of Service Edit: Clinical
L1010 0 3 Date of Service Edit: Clinical
L1020 0 3 Date of Service Edit: Clinical
L1025 0 3 Date of Service Edit: Clinical
L1030 0 3 Date of Service Edit: Clinical
L1040 0 3 Date of Service Edit: Clinical
L1050 0 3 Date of Service Edit: Clinical
L1060 0 3 Date of Service Edit: Clinical
L1070 0 3 Date of Service Edit: Clinical
HCPCS/CPT Code
Practitioner Services
MUE ValuesMUE Adjudication
IndicatorL1080 0 3 Date of Service Edit: Clinical
L1085 0 3 Date of Service Edit: Clinical
L1090 0 3 Date of Service Edit: Clinical
L1100 0 3 Date of Service Edit: Clinical
L1110 0 3 Date of Service Edit: Clinical
L1120 0 3 Date of Service Edit: Clinical
L1200 0 3 Date of Service Edit: Clinical
L1210 0 3 Date of Service Edit: Clinical
L1220 0 3 Date of Service Edit: Clinical
L1230 0 3 Date of Service Edit: Clinical
L1240 0 3 Date of Service Edit: Clinical
L1250 0 3 Date of Service Edit: Clinical
L1260 0 3 Date of Service Edit: Clinical
L1270 0 3 Date of Service Edit: Clinical
L1280 0 3 Date of Service Edit: Clinical
L1290 0 3 Date of Service Edit: Clinical
L1300 0 3 Date of Service Edit: Clinical
L1310 0 3 Date of Service Edit: Clinical
L1499 1 3 Date of Service Edit: Clinical
L1600 0 3 Date of Service Edit: Clinical
L1610 0 3 Date of Service Edit: Clinical
L1620 0 3 Date of Service Edit: Clinical
L1630 0 3 Date of Service Edit: Clinical
L1640 0 3 Date of Service Edit: Clinical
L1650 0 3 Date of Service Edit: Clinical
L1652 0 3 Date of Service Edit: Clinical
L1660 0 3 Date of Service Edit: Clinical
L1680 0 3 Date of Service Edit: Clinical
L1685 0 3 Date of Service Edit: Clinical
L1686 0 3 Date of Service Edit: Clinical
L1690 0 3 Date of Service Edit: Clinical
L1700 0 3 Date of Service Edit: Clinical
L1710 0 3 Date of Service Edit: Clinical
L1720 0 3 Date of Service Edit: Clinical
L1730 0 3 Date of Service Edit: Clinical
L1755 0 3 Date of Service Edit: Clinical
L1810 0 3 Date of Service Edit: Clinical
L1812 0 3 Date of Service Edit: Clinical
L1820 0 3 Date of Service Edit: Clinical
L1830 0 3 Date of Service Edit: Clinical
L1831 0 3 Date of Service Edit: Clinical
L1832 0 3 Date of Service Edit: Clinical
L1833 0 3 Date of Service Edit: Clinical
L1834 0 3 Date of Service Edit: Clinical
16
PRACTITIONER EDITS2015 PR
ACTITIO
NER
/DM
E MU
E
HCPCS/CPT Code
Practitioner Services
MUE ValuesMUE Adjudication
IndicatorL1836 0 3 Date of Service Edit: Clinical
L1840 0 3 Date of Service Edit: Clinical
L1843 0 3 Date of Service Edit: Clinical
L1844 0 3 Date of Service Edit: Clinical
L1845 0 3 Date of Service Edit: Clinical
L1846 0 3 Date of Service Edit: Clinical
L1847 0 3 Date of Service Edit: Clinical
L1848 0 3 Date of Service Edit: Clinical
L1850 0 3 Date of Service Edit: Clinical
L1860 0 3 Date of Service Edit: Clinical
L1900 0 3 Date of Service Edit: Clinical
L1902 0 3 Date of Service Edit: Clinical
L1904 0 3 Date of Service Edit: Clinical
L1906 0 3 Date of Service Edit: Clinical
L1907 0 3 Date of Service Edit: Clinical
L1910 0 3 Date of Service Edit: Clinical
L1920 0 3 Date of Service Edit: Clinical
L1930 0 3 Date of Service Edit: Clinical
L1932 0 3 Date of Service Edit: Clinical
L1940 0 3 Date of Service Edit: Clinical
L1945 0 3 Date of Service Edit: Clinical
L1950 0 3 Date of Service Edit: Clinical
L1951 0 3 Date of Service Edit: Clinical
L1960 0 3 Date of Service Edit: Clinical
L1970 0 3 Date of Service Edit: Clinical
L1971 0 3 Date of Service Edit: Clinical
L1980 0 3 Date of Service Edit: Clinical
L1990 0 3 Date of Service Edit: Clinical
L2000 0 3 Date of Service Edit: Clinical
L2005 0 3 Date of Service Edit: Clinical
L2010 0 3 Date of Service Edit: Clinical
L2020 0 3 Date of Service Edit: Clinical
L2030 0 3 Date of Service Edit: Clinical
L2034 0 3 Date of Service Edit: Clinical
L2035 0 3 Date of Service Edit: Clinical
L2036 0 3 Date of Service Edit: Clinical
L2037 0 3 Date of Service Edit: Clinical
L2038 0 3 Date of Service Edit: Clinical
L2040 0 3 Date of Service Edit: Clinical
L2050 0 3 Date of Service Edit: Clinical
L2060 0 3 Date of Service Edit: Clinical
L2070 0 3 Date of Service Edit: Clinical
L2080 0 3 Date of Service Edit: Clinical
L2090 0 3 Date of Service Edit: Clinical
HCPCS/CPT Code
Practitioner Services
MUE ValuesMUE Adjudication
IndicatorL2106 0 3 Date of Service Edit: Clinical
L2108 0 3 Date of Service Edit: Clinical
L2112 0 3 Date of Service Edit: Clinical
L2114 0 3 Date of Service Edit: Clinical
L2116 0 3 Date of Service Edit: Clinical
L2126 0 3 Date of Service Edit: Clinical
L2128 0 3 Date of Service Edit: Clinical
L2132 0 3 Date of Service Edit: Clinical
L2134 0 3 Date of Service Edit: Clinical
L2136 0 3 Date of Service Edit: Clinical
L2180 0 3 Date of Service Edit: Clinical
L2182 0 3 Date of Service Edit: Clinical
L2184 0 3 Date of Service Edit: Clinical
L2186 0 3 Date of Service Edit: Clinical
L2188 0 3 Date of Service Edit: Clinical
L2190 0 3 Date of Service Edit: Clinical
L2192 0 3 Date of Service Edit: Clinical
L2200 0 3 Date of Service Edit: Clinical
L2210 0 3 Date of Service Edit: Clinical
L2220 0 3 Date of Service Edit: Clinical
L2230 0 3 Date of Service Edit: Clinical
L2232 0 3 Date of Service Edit: Clinical
L2240 0 3 Date of Service Edit: Clinical
L2250 0 3 Date of Service Edit: Clinical
L2260 0 3 Date of Service Edit: Clinical
L2265 0 3 Date of Service Edit: Clinical
L2270 0 3 Date of Service Edit: Clinical
L2275 0 3 Date of Service Edit: Clinical
L2280 0 3 Date of Service Edit: Clinical
L2300 0 3 Date of Service Edit: Clinical
L2310 0 3 Date of Service Edit: Clinical
L2320 0 3 Date of Service Edit: Clinical
L2330 0 3 Date of Service Edit: Clinical
L2335 0 3 Date of Service Edit: Clinical
L2340 0 3 Date of Service Edit: Clinical
L2350 0 3 Date of Service Edit: Clinical
L2360 0 3 Date of Service Edit: Clinical
L2370 0 3 Date of Service Edit: Clinical
L2375 0 3 Date of Service Edit: Clinical
L2380 0 3 Date of Service Edit: Clinical
L2385 0 3 Date of Service Edit: Clinical
L2387 0 3 Date of Service Edit: Clinical
L2390 0 3 Date of Service Edit: Clinical
L2395 0 3 Date of Service Edit: Clinical
17
2015 HCPCS: LEVEL II NATIONAL CODES20
15 P
RA
CTIT
ION
ER/D
ME
MU
E
HCPCS/CPT Code
Practitioner Services
MUE ValuesMUE Adjudication
IndicatorL2397 0 3 Date of Service Edit: Clinical
L2405 0 3 Date of Service Edit: Clinical
L2415 0 3 Date of Service Edit: Clinical
L2425 0 3 Date of Service Edit: Clinical
L2430 0 3 Date of Service Edit: Clinical
L2492 0 3 Date of Service Edit: Clinical
L2500 0 3 Date of Service Edit: Clinical
L2510 0 3 Date of Service Edit: Clinical
L2520 0 3 Date of Service Edit: Clinical
L2525 0 3 Date of Service Edit: Clinical
L2526 0 3 Date of Service Edit: Clinical
L2530 0 3 Date of Service Edit: Clinical
L2540 0 3 Date of Service Edit: Clinical
L2550 0 3 Date of Service Edit: Clinical
L2570 0 3 Date of Service Edit: Clinical
L2580 0 3 Date of Service Edit: Clinical
L2600 0 3 Date of Service Edit: Clinical
L2610 0 3 Date of Service Edit: Clinical
L2620 0 3 Date of Service Edit: Clinical
L2622 0 3 Date of Service Edit: Clinical
L2624 0 3 Date of Service Edit: Clinical
L2627 0 3 Date of Service Edit: Clinical
L2628 0 3 Date of Service Edit: Clinical
L2630 0 3 Date of Service Edit: Clinical
L2640 0 3 Date of Service Edit: Clinical
L2650 0 3 Date of Service Edit: Clinical
L2660 0 3 Date of Service Edit: Clinical
L2670 0 3 Date of Service Edit: Clinical
L2680 0 3 Date of Service Edit: Clinical
L2750 0 3 Date of Service Edit: Clinical
L2755 0 3 Date of Service Edit: Clinical
L2760 0 3 Date of Service Edit: Clinical
L2768 0 3 Date of Service Edit: Clinical
L2780 0 3 Date of Service Edit: Clinical
L2785 0 3 Date of Service Edit: Clinical
L2795 0 3 Date of Service Edit: Clinical
L2800 0 3 Date of Service Edit: Clinical
L2810 0 3 Date of Service Edit: Clinical
L2820 0 3 Date of Service Edit: Clinical
L2830 0 3 Date of Service Edit: Clinical
L3000 0 3 Date of Service Edit: Clinical
L3001 0 3 Date of Service Edit: Clinical
L3002 0 3 Date of Service Edit: Clinical
L3003 0 3 Date of Service Edit: Clinical
HCPCS/CPT Code
Practitioner Services
MUE ValuesMUE Adjudication
IndicatorL3010 0 3 Date of Service Edit: Clinical
L3020 0 3 Date of Service Edit: Clinical
L3030 0 3 Date of Service Edit: Clinical
L3031 0 3 Date of Service Edit: Clinical
L3040 0 3 Date of Service Edit: Clinical
L3050 0 3 Date of Service Edit: Clinical
L3060 0 3 Date of Service Edit: Clinical
L3070 0 3 Date of Service Edit: Clinical
L3080 0 3 Date of Service Edit: Clinical
L3090 0 3 Date of Service Edit: Clinical
L3100 0 3 Date of Service Edit: Clinical
L3140 0 3 Date of Service Edit: Clinical
L3150 0 3 Date of Service Edit: Clinical
L3160 0 3 Date of Service Edit: Clinical
L3170 0 3 Date of Service Edit: Clinical
L3215 0 3 Date of Service Edit: Clinical
L3216 0 3 Date of Service Edit: Clinical
L3217 0 3 Date of Service Edit: Clinical
L3219 0 3 Date of Service Edit: Clinical
L3221 0 3 Date of Service Edit: Clinical
L3222 0 3 Date of Service Edit: Clinical
L3224 0 3 Date of Service Edit: Clinical
L3225 0 3 Date of Service Edit: Clinical
L3230 0 3 Date of Service Edit: Clinical
L3250 0 3 Date of Service Edit: Clinical
L3251 0 3 Date of Service Edit: Clinical
L3252 0 3 Date of Service Edit: Clinical
L3253 0 3 Date of Service Edit: Clinical
L3300 0 3 Date of Service Edit: Clinical
L3310 0 3 Date of Service Edit: Clinical
L3330 0 3 Date of Service Edit: Clinical
L3332 0 3 Date of Service Edit: Clinical
L3334 0 3 Date of Service Edit: Clinical
L3340 0 3 Date of Service Edit: Clinical
L3350 0 3 Date of Service Edit: Clinical
L3360 0 3 Date of Service Edit: Clinical
L3370 0 3 Date of Service Edit: Clinical
L3380 0 3 Date of Service Edit: Clinical
L3390 0 3 Date of Service Edit: Clinical
L3400 0 3 Date of Service Edit: Clinical
L3410 0 3 Date of Service Edit: Clinical
L3420 0 3 Date of Service Edit: Clinical
L3430 0 3 Date of Service Edit: Clinical
L3440 0 3 Date of Service Edit: Clinical
18
PRACTITIONER EDITS2015 PR
ACTITIO
NER
/DM
E MU
E
HCPCS/CPT Code
Practitioner Services
MUE ValuesMUE Adjudication
IndicatorL3450 0 3 Date of Service Edit: Clinical
L3455 0 3 Date of Service Edit: Clinical
L3460 0 3 Date of Service Edit: Clinical
L3465 0 3 Date of Service Edit: Clinical
L3470 0 3 Date of Service Edit: Clinical
L3480 0 3 Date of Service Edit: Clinical
L3485 0 3 Date of Service Edit: Clinical
L3500 0 3 Date of Service Edit: Clinical
L3510 0 3 Date of Service Edit: Clinical
L3520 0 3 Date of Service Edit: Clinical
L3530 0 3 Date of Service Edit: Clinical
L3540 0 3 Date of Service Edit: Clinical
L3550 0 3 Date of Service Edit: Clinical
L3560 0 3 Date of Service Edit: Clinical
L3570 0 3 Date of Service Edit: Clinical
L3580 0 3 Date of Service Edit: Clinical
L3590 0 3 Date of Service Edit: Clinical
L3595 0 3 Date of Service Edit: Clinical
L3600 0 3 Date of Service Edit: Clinical
L3610 0 3 Date of Service Edit: Clinical
L3620 0 3 Date of Service Edit: Clinical
L3630 0 3 Date of Service Edit: Clinical
L3640 0 3 Date of Service Edit: Clinical
L3650 0 3 Date of Service Edit: Clinical
L3660 0 3 Date of Service Edit: Clinical
L3670 0 3 Date of Service Edit: Clinical
L3671 0 3 Date of Service Edit: Clinical
L3674 0 3 Date of Service Edit: Clinical
L3675 0 3 Date of Service Edit: Clinical
L3677 0 3 Date of Service Edit: Clinical
L3678 0 3 Date of Service Edit: Clinical
L3702 0 3 Date of Service Edit: Clinical
L3710 0 3 Date of Service Edit: Clinical
L3720 0 3 Date of Service Edit: Clinical
L3730 0 3 Date of Service Edit: Clinical
L3740 0 3 Date of Service Edit: Clinical
L3760 0 3 Date of Service Edit: Clinical
L3762 0 3 Date of Service Edit: Clinical
L3763 0 3 Date of Service Edit: Clinical
L3764 0 3 Date of Service Edit: Clinical
L3765 0 3 Date of Service Edit: Clinical
L3766 0 3 Date of Service Edit: Clinical
L3806 0 3 Date of Service Edit: Clinical
L3807 0 3 Date of Service Edit: Clinical
HCPCS/CPT Code
Practitioner Services
MUE ValuesMUE Adjudication
IndicatorL3808 0 3 Date of Service Edit: Clinical
L3809 0 3 Date of Service Edit: Clinical
L3900 0 3 Date of Service Edit: Clinical
L3901 0 3 Date of Service Edit: Clinical
L3904 0 3 Date of Service Edit: Clinical
L3905 0 3 Date of Service Edit: Clinical
L3906 0 3 Date of Service Edit: Clinical
L3908 0 3 Date of Service Edit: Clinical
L3912 0 3 Date of Service Edit: Clinical
L3913 0 3 Date of Service Edit: Clinical
L3915 0 3 Date of Service Edit: Clinical
L3916 0 3 Date of Service Edit: Clinical
L3917 0 3 Date of Service Edit: Clinical
L3918 0 3 Date of Service Edit: Clinical
L3919 0 3 Date of Service Edit: Clinical
L3921 0 3 Date of Service Edit: Clinical
L3923 0 3 Date of Service Edit: Clinical
L3924 0 3 Date of Service Edit: Clinical
L3925 0 3 Date of Service Edit: Clinical
L3927 0 3 Date of Service Edit: Clinical
L3929 0 3 Date of Service Edit: Clinical
L3930 0 3 Date of Service Edit: Clinical
L3931 0 3 Date of Service Edit: Clinical
L3933 0 3 Date of Service Edit: Clinical
L3935 0 3 Date of Service Edit: Clinical
L3956 0 3 Date of Service Edit: Clinical
L3960 0 3 Date of Service Edit: Clinical
L3961 0 3 Date of Service Edit: Clinical
L3962 0 3 Date of Service Edit: Clinical
L3967 0 3 Date of Service Edit: Clinical
L3971 0 3 Date of Service Edit: Clinical
L3973 0 3 Date of Service Edit: Clinical
L3975 0 3 Date of Service Edit: Clinical
L3976 0 3 Date of Service Edit: Clinical
L3977 0 3 Date of Service Edit: Clinical
L3978 0 3 Date of Service Edit: Clinical
L3980 0 3 Date of Service Edit: Clinical
L3982 0 3 Date of Service Edit: Clinical
L3984 0 3 Date of Service Edit: Clinical
L4000 0 3 Date of Service Edit: Clinical
L4002 0 3 Date of Service Edit: Clinical
L4010 0 3 Date of Service Edit: Clinical
L4020 0 3 Date of Service Edit: Clinical
L4030 0 3 Date of Service Edit: Clinical
19
2015 HCPCS: LEVEL II NATIONAL CODES20
15 P
RA
CTIT
ION
ER/D
ME
MU
E
HCPCS/CPT Code
Practitioner Services
MUE ValuesMUE Adjudication
IndicatorL4040 0 3 Date of Service Edit: Clinical
L4045 0 3 Date of Service Edit: Clinical
L4050 0 3 Date of Service Edit: Clinical
L4055 0 3 Date of Service Edit: Clinical
L4060 0 3 Date of Service Edit: Clinical
L4070 0 3 Date of Service Edit: Clinical
L4080 0 3 Date of Service Edit: Clinical
L4090 0 3 Date of Service Edit: Clinical
L4100 0 3 Date of Service Edit: Clinical
L4110 0 3 Date of Service Edit: Clinical
L4130 0 3 Date of Service Edit: Clinical
L4205 0 3 Date of Service Edit: Clinical
L4210 0 3 Date of Service Edit: Clinical
L4350 0 3 Date of Service Edit: Clinical
L4360 0 3 Date of Service Edit: Clinical
L4361 0 3 Date of Service Edit: Clinical
L4370 0 3 Date of Service Edit: Clinical
L4386 0 3 Date of Service Edit: Clinical
L4387 0 3 Date of Service Edit: Clinical
L4392 0 3 Date of Service Edit: Clinical
L4394 0 3 Date of Service Edit: Clinical
L4396 0 3 Date of Service Edit: Clinical
L4397 0 3 Date of Service Edit: Clinical
L4398 0 3 Date of Service Edit: Clinical
L4631 0 3 Date of Service Edit: Clinical
L5000 0 3 Date of Service Edit: Clinical
L5010 0 3 Date of Service Edit: Clinical
L5020 0 3 Date of Service Edit: Clinical
L5050 0 3 Date of Service Edit: Clinical
L5060 0 3 Date of Service Edit: Clinical
L5100 0 3 Date of Service Edit: Clinical
L5105 0 3 Date of Service Edit: Clinical
L5150 0 3 Date of Service Edit: Clinical
L5160 0 3 Date of Service Edit: Clinical
L5200 0 3 Date of Service Edit: Clinical
L5210 0 3 Date of Service Edit: Clinical
L5220 0 3 Date of Service Edit: Clinical
L5230 0 3 Date of Service Edit: Clinical
L5250 0 3 Date of Service Edit: Clinical
L5270 0 3 Date of Service Edit: Clinical
L5280 0 3 Date of Service Edit: Clinical
L5301 0 3 Date of Service Edit: Clinical
L5312 0 3 Date of Service Edit: Clinical
L5321 0 3 Date of Service Edit: Clinical
HCPCS/CPT Code
Practitioner Services
MUE ValuesMUE Adjudication
IndicatorL5331 0 3 Date of Service Edit: Clinical
L5341 0 3 Date of Service Edit: Clinical
L5400 0 3 Date of Service Edit: Clinical
L5410 0 3 Date of Service Edit: Clinical
L5420 0 3 Date of Service Edit: Clinical
L5430 0 3 Date of Service Edit: Clinical
L5450 0 3 Date of Service Edit: Clinical
L5460 0 3 Date of Service Edit: Clinical
L5500 0 3 Date of Service Edit: Clinical
L5505 0 3 Date of Service Edit: Clinical
L5510 0 3 Date of Service Edit: Clinical
L5520 0 3 Date of Service Edit: Clinical
L5530 0 3 Date of Service Edit: Clinical
L5535 0 3 Date of Service Edit: Clinical
L5540 0 3 Date of Service Edit: Clinical
L5560 0 3 Date of Service Edit: Clinical
L5570 0 3 Date of Service Edit: Clinical
L5580 0 3 Date of Service Edit: Clinical
L5585 0 3 Date of Service Edit: Clinical
L5590 0 3 Date of Service Edit: Clinical
L5595 0 3 Date of Service Edit: Clinical
L5600 0 3 Date of Service Edit: Clinical
L5610 0 3 Date of Service Edit: Clinical
L5611 0 3 Date of Service Edit: Clinical
L5613 0 3 Date of Service Edit: Clinical
L5614 0 3 Date of Service Edit: Clinical
L5616 0 3 Date of Service Edit: Clinical
L5617 0 3 Date of Service Edit: Clinical
L5618 0 3 Date of Service Edit: Clinical
L5620 0 3 Date of Service Edit: Clinical
L5622 0 3 Date of Service Edit: Clinical
L5624 0 3 Date of Service Edit: Clinical
L5626 0 3 Date of Service Edit: Clinical
L5628 0 3 Date of Service Edit: Clinical
L5629 0 3 Date of Service Edit: Clinical
L5630 0 3 Date of Service Edit: Clinical
L5631 0 3 Date of Service Edit: Clinical
L5632 0 3 Date of Service Edit: Clinical
L5634 0 3 Date of Service Edit: Clinical
L5636 0 3 Date of Service Edit: Clinical
L5637 0 3 Date of Service Edit: Clinical
L5638 0 3 Date of Service Edit: Clinical
L5639 0 3 Date of Service Edit: Clinical
L5640 0 3 Date of Service Edit: Clinical
20
PRACTITIONER EDITS2015 PR
ACTITIO
NER
/DM
E MU
E
HCPCS/CPT Code
Practitioner Services
MUE ValuesMUE Adjudication
IndicatorL5642 0 3 Date of Service Edit: Clinical
L5643 0 3 Date of Service Edit: Clinical
L5644 0 3 Date of Service Edit: Clinical
L5645 0 3 Date of Service Edit: Clinical
L5646 0 3 Date of Service Edit: Clinical
L5647 0 3 Date of Service Edit: Clinical
L5648 0 3 Date of Service Edit: Clinical
L5649 0 3 Date of Service Edit: Clinical
L5650 0 3 Date of Service Edit: Clinical
L5651 0 3 Date of Service Edit: Clinical
L5652 0 3 Date of Service Edit: Clinical
L5653 0 3 Date of Service Edit: Clinical
L5654 0 3 Date of Service Edit: Clinical
L5655 0 3 Date of Service Edit: Clinical
L5656 0 3 Date of Service Edit: Clinical
L5658 0 3 Date of Service Edit: Clinical
L5661 0 3 Date of Service Edit: Clinical
L5665 0 3 Date of Service Edit: Clinical
L5666 0 3 Date of Service Edit: Clinical
L5668 0 3 Date of Service Edit: Clinical
L5670 0 3 Date of Service Edit: Clinical
L5671 0 3 Date of Service Edit: Clinical
L5672 0 3 Date of Service Edit: Clinical
L5673 0 3 Date of Service Edit: Clinical
L5676 0 3 Date of Service Edit: Clinical
L5677 0 3 Date of Service Edit: Clinical
L5678 0 3 Date of Service Edit: Clinical
L5679 0 3 Date of Service Edit: Clinical
L5680 0 3 Date of Service Edit: Clinical
L5681 0 3 Date of Service Edit: Clinical
L5682 0 3 Date of Service Edit: Clinical
L5683 0 3 Date of Service Edit: Clinical
L5684 0 3 Date of Service Edit: Clinical
L5685 0 3 Date of Service Edit: Clinical
L5686 0 3 Date of Service Edit: Clinical
L5688 0 3 Date of Service Edit: Clinical
L5690 0 3 Date of Service Edit: Clinical
L5692 0 3 Date of Service Edit: Clinical
L5694 0 3 Date of Service Edit: Clinical
L5695 0 3 Date of Service Edit: Clinical
L5696 0 3 Date of Service Edit: Clinical
L5697 0 3 Date of Service Edit: Clinical
L5698 0 3 Date of Service Edit: Clinical
L5699 0 3 Date of Service Edit: Clinical
HCPCS/CPT Code
Practitioner Services
MUE ValuesMUE Adjudication
IndicatorL5700 0 3 Date of Service Edit: Clinical
L5701 0 3 Date of Service Edit: Clinical
L5702 0 3 Date of Service Edit: Clinical
L5703 0 3 Date of Service Edit: Clinical
L5704 0 3 Date of Service Edit: Clinical
L5705 0 3 Date of Service Edit: Clinical
L5706 0 3 Date of Service Edit: Clinical
L5707 0 3 Date of Service Edit: Clinical
L5710 0 3 Date of Service Edit: Clinical
L5711 0 3 Date of Service Edit: Clinical
L5712 0 3 Date of Service Edit: Clinical
L5714 0 3 Date of Service Edit: Clinical
L5716 0 3 Date of Service Edit: Clinical
L5718 0 3 Date of Service Edit: Clinical
L5722 0 3 Date of Service Edit: Clinical
L5724 0 3 Date of Service Edit: Clinical
L5726 0 3 Date of Service Edit: Clinical
L5728 0 3 Date of Service Edit: Clinical
L5780 0 3 Date of Service Edit: Clinical
L5781 0 3 Date of Service Edit: Clinical
L5782 0 3 Date of Service Edit: Clinical
L5785 0 3 Date of Service Edit: Clinical
L5790 0 3 Date of Service Edit: Clinical
L5795 0 3 Date of Service Edit: Clinical
L5810 0 3 Date of Service Edit: Clinical
L5811 0 3 Date of Service Edit: Clinical
L5812 0 3 Date of Service Edit: Clinical
L5814 0 3 Date of Service Edit: Clinical
L5816 0 3 Date of Service Edit: Clinical
L5818 0 3 Date of Service Edit: Clinical
L5822 0 3 Date of Service Edit: Clinical
L5824 0 3 Date of Service Edit: Clinical
L5826 0 3 Date of Service Edit: Clinical
L5828 0 3 Date of Service Edit: Clinical
L5830 0 3 Date of Service Edit: Clinical
L5840 0 3 Date of Service Edit: Clinical
L5845 0 3 Date of Service Edit: Clinical
L5848 0 3 Date of Service Edit: Clinical
L5850 0 3 Date of Service Edit: Clinical
L5855 0 3 Date of Service Edit: Clinical
L5856 0 3 Date of Service Edit: Clinical
L5857 0 3 Date of Service Edit: Clinical
L5858 0 3 Date of Service Edit: Clinical
L5859 0 3 Date of Service Edit: Clinical
21
2015 HCPCS: LEVEL II NATIONAL CODES20
15 P
RA
CTIT
ION
ER/D
ME
MU
E
HCPCS/CPT Code
Practitioner Services
MUE ValuesMUE Adjudication
IndicatorL5910 0 3 Date of Service Edit: Clinical
L5920 0 3 Date of Service Edit: Clinical
L5925 0 3 Date of Service Edit: Clinical
L5930 0 3 Date of Service Edit: Clinical
L5940 0 3 Date of Service Edit: Clinical
L5950 0 3 Date of Service Edit: Clinical
L5960 0 3 Date of Service Edit: Clinical
L5961 0 3 Date of Service Edit: Clinical
L5962 0 3 Date of Service Edit: Clinical
L5964 0 3 Date of Service Edit: Clinical
L5966 0 3 Date of Service Edit: Clinical
L5968 0 3 Date of Service Edit: Clinical
L5969 0 3 Date of Service Edit: Clinical
L5970 0 3 Date of Service Edit: Clinical
L5971 0 3 Date of Service Edit: Clinical
L5972 0 3 Date of Service Edit: Clinical
L5974 0 3 Date of Service Edit: Clinical
L5975 0 3 Date of Service Edit: Clinical
L5976 0 3 Date of Service Edit: Clinical
L5978 0 3 Date of Service Edit: Clinical
L5979 0 3 Date of Service Edit: Clinical
L5980 0 3 Date of Service Edit: Clinical
L5981 0 3 Date of Service Edit: Clinical
L5982 0 3 Date of Service Edit: Clinical
L5984 0 3 Date of Service Edit: Clinical
L5985 0 3 Date of Service Edit: Clinical
L5986 0 3 Date of Service Edit: Clinical
L5987 0 3 Date of Service Edit: Clinical
L5988 0 3 Date of Service Edit: Clinical
L5990 0 3 Date of Service Edit: Clinical
L6000 0 3 Date of Service Edit: Clinical
L6010 0 3 Date of Service Edit: Clinical
L6020 0 3 Date of Service Edit: Clinical
L6025 0 3 Date of Service Edit: Clinical
L6050 0 3 Date of Service Edit: Clinical
L6055 0 3 Date of Service Edit: Clinical
L6100 0 3 Date of Service Edit: Clinical
L6110 0 3 Date of Service Edit: Clinical
L6120 0 3 Date of Service Edit: Clinical
L6130 0 3 Date of Service Edit: Clinical
L6200 0 3 Date of Service Edit: Clinical
L6205 0 3 Date of Service Edit: Clinical
L6250 0 3 Date of Service Edit: Clinical
L6300 0 3 Date of Service Edit: Clinical
HCPCS/CPT Code
Practitioner Services
MUE ValuesMUE Adjudication
IndicatorL6310 0 3 Date of Service Edit: Clinical
L6320 0 3 Date of Service Edit: Clinical
L6350 0 3 Date of Service Edit: Clinical
L6360 0 3 Date of Service Edit: Clinical
L6370 0 3 Date of Service Edit: Clinical
L6380 0 3 Date of Service Edit: Clinical
L6382 0 3 Date of Service Edit: Clinical
L6384 0 3 Date of Service Edit: Clinical
L6386 0 3 Date of Service Edit: Clinical
L6388 0 3 Date of Service Edit: Clinical
L6400 0 3 Date of Service Edit: Clinical
L6450 0 3 Date of Service Edit: Clinical
L6500 0 3 Date of Service Edit: Clinical
L6550 0 3 Date of Service Edit: Clinical
L6570 0 3 Date of Service Edit: Clinical
L6580 0 3 Date of Service Edit: Clinical
L6582 0 3 Date of Service Edit: Clinical
L6584 0 3 Date of Service Edit: Clinical
L6586 0 3 Date of Service Edit: Clinical
L6588 0 3 Date of Service Edit: Clinical
L6590 0 3 Date of Service Edit: Clinical
L6600 0 3 Date of Service Edit: Clinical
L6605 0 3 Date of Service Edit: Clinical
L6610 0 3 Date of Service Edit: Clinical
L6611 0 3 Date of Service Edit: Clinical
L6615 0 3 Date of Service Edit: Clinical
L6616 0 3 Date of Service Edit: Clinical
L6620 0 3 Date of Service Edit: Clinical
L6621 0 3 Date of Service Edit: Clinical
L6623 0 3 Date of Service Edit: Clinical
L6624 0 3 Date of Service Edit: Clinical
L6625 0 3 Date of Service Edit: Clinical
L6628 0 3 Date of Service Edit: Clinical
L6629 0 3 Date of Service Edit: Clinical
L6630 0 3 Date of Service Edit: Clinical
L6632 0 3 Date of Service Edit: Clinical
L6635 0 3 Date of Service Edit: Clinical
L6637 0 3 Date of Service Edit: Clinical
L6638 0 3 Date of Service Edit: Clinical
L6640 0 3 Date of Service Edit: Clinical
L6641 0 3 Date of Service Edit: Clinical
L6642 0 3 Date of Service Edit: Clinical
L6645 0 3 Date of Service Edit: Clinical
L6646 0 3 Date of Service Edit: Clinical
22
PRACTITIONER EDITS2015 PR
ACTITIO
NER
/DM
E MU
E
HCPCS/CPT Code
Practitioner Services
MUE ValuesMUE Adjudication
IndicatorL6647 0 3 Date of Service Edit: Clinical
L6648 0 3 Date of Service Edit: Clinical
L6650 0 3 Date of Service Edit: Clinical
L6655 0 3 Date of Service Edit: Clinical
L6660 0 3 Date of Service Edit: Clinical
L6665 0 3 Date of Service Edit: Clinical
L6670 0 3 Date of Service Edit: Clinical
L6672 0 3 Date of Service Edit: Clinical
L6675 0 3 Date of Service Edit: Clinical
L6676 0 3 Date of Service Edit: Clinical
L6677 0 3 Date of Service Edit: Clinical
L6680 0 3 Date of Service Edit: Clinical
L6682 0 3 Date of Service Edit: Clinical
L6684 0 3 Date of Service Edit: Clinical
L6686 0 3 Date of Service Edit: Clinical
L6687 0 3 Date of Service Edit: Clinical
L6688 0 3 Date of Service Edit: Clinical
L6689 0 3 Date of Service Edit: Clinical
L6690 0 3 Date of Service Edit: Clinical
L6691 0 3 Date of Service Edit: Clinical
L6692 0 3 Date of Service Edit: Clinical
L6693 0 3 Date of Service Edit: Clinical
L6694 0 3 Date of Service Edit: Clinical
L6695 0 3 Date of Service Edit: Clinical
L6696 0 3 Date of Service Edit: Clinical
L6697 0 3 Date of Service Edit: Clinical
L6698 0 3 Date of Service Edit: Clinical
L6703 0 3 Date of Service Edit: Clinical
L6704 0 3 Date of Service Edit: Clinical
L6706 0 3 Date of Service Edit: Clinical
L6707 0 3 Date of Service Edit: Clinical
L6708 0 3 Date of Service Edit: Clinical
L6709 0 3 Date of Service Edit: Clinical
L6711 0 3 Date of Service Edit: Clinical
L6712 0 3 Date of Service Edit: Clinical
L6713 0 3 Date of Service Edit: Clinical
L6714 0 3 Date of Service Edit: Clinical
L6715 0 3 Date of Service Edit: Clinical
L6721 0 3 Date of Service Edit: Clinical
L6722 0 3 Date of Service Edit: Clinical
L6805 0 3 Date of Service Edit: Clinical
L6810 0 3 Date of Service Edit: Clinical
L6880 0 3 Date of Service Edit: Clinical
L6881 0 3 Date of Service Edit: Clinical
HCPCS/CPT Code
Practitioner Services
MUE ValuesMUE Adjudication
IndicatorL6882 0 3 Date of Service Edit: Clinical
L6883 0 3 Date of Service Edit: Clinical
L6884 0 3 Date of Service Edit: Clinical
L6885 0 3 Date of Service Edit: Clinical
L6890 0 3 Date of Service Edit: Clinical
L6895 0 3 Date of Service Edit: Clinical
L6900 0 3 Date of Service Edit: Clinical
L6905 0 3 Date of Service Edit: Clinical
L6910 0 3 Date of Service Edit: Clinical
L6915 0 3 Date of Service Edit: Clinical
L6920 0 3 Date of Service Edit: Clinical
L6925 0 3 Date of Service Edit: Clinical
L6930 0 3 Date of Service Edit: Clinical
L6935 0 3 Date of Service Edit: Clinical
L6940 0 3 Date of Service Edit: Clinical
L6945 0 3 Date of Service Edit: Clinical
L6950 0 3 Date of Service Edit: Clinical
L6955 0 3 Date of Service Edit: Clinical
L6960 0 3 Date of Service Edit: Clinical
L6965 0 3 Date of Service Edit: Clinical
L6970 0 3 Date of Service Edit: Clinical
L6975 0 3 Date of Service Edit: Clinical
L7007 0 3 Date of Service Edit: Clinical
L7008 0 3 Date of Service Edit: Clinical
L7009 0 3 Date of Service Edit: Clinical
L7040 0 3 Date of Service Edit: Clinical
L7045 0 3 Date of Service Edit: Clinical
L7170 0 3 Date of Service Edit: Clinical
L7180 0 3 Date of Service Edit: Clinical
L7181 0 3 Date of Service Edit: Clinical
L7185 0 3 Date of Service Edit: Clinical
L7186 0 3 Date of Service Edit: Clinical
L7190 0 3 Date of Service Edit: Clinical
L7191 0 3 Date of Service Edit: Clinical
L7260 0 3 Date of Service Edit: Clinical
L7261 0 3 Date of Service Edit: Clinical
L7360 0 3 Date of Service Edit: Clinical
L7362 0 3 Date of Service Edit: Clinical
L7364 0 3 Date of Service Edit: Clinical
L7366 0 3 Date of Service Edit: Clinical
L7367 0 3 Date of Service Edit: Clinical
L7368 0 3 Date of Service Edit: Clinical
L7400 0 3 Date of Service Edit: Clinical
L7401 0 3 Date of Service Edit: Clinical
23
2015 HCPCS: LEVEL II NATIONAL CODES20
15 P
RA
CTIT
ION
ER/D
ME
MU
E
HCPCS/CPT Code
Practitioner Services
MUE ValuesMUE Adjudication
IndicatorL7402 0 3 Date of Service Edit: Clinical
L7403 0 3 Date of Service Edit: Clinical
L7404 0 3 Date of Service Edit: Clinical
L7405 0 3 Date of Service Edit: Clinical
L7900 0 3 Date of Service Edit: Clinical
L7902 0 3 Date of Service Edit: Clinical
L8000 0 3 Date of Service Edit: Clinical
L8001 0 3 Date of Service Edit: Clinical
L8002 0 3 Date of Service Edit: Clinical
L8015 0 3 Date of Service Edit: Clinical
L8020 0 3 Date of Service Edit: Clinical
L8030 0 3 Date of Service Edit: Clinical
L8031 0 3 Date of Service Edit: Clinical
L8032 0 3 Date of Service Edit: Clinical
L8035 0 3 Date of Service Edit: Clinical
L8039 0 3 Date of Service Edit: Clinical
L8040 0 3 Date of Service Edit: Clinical
L8041 0 3 Date of Service Edit: Clinical
L8042 0 3 Date of Service Edit: Clinical
L8043 0 3 Date of Service Edit: Clinical
L8044 0 3 Date of Service Edit: Clinical
L8045 0 3 Date of Service Edit: Clinical
L8046 0 3 Date of Service Edit: Clinical
L8047 0 3 Date of Service Edit: Clinical
L8048 1 3 Date of Service Edit: Clinical
L8049 0 3 Date of Service Edit: Clinical
L8300 0 3 Date of Service Edit: Clinical
L8310 0 3 Date of Service Edit: Clinical
L8320 0 3 Date of Service Edit: Clinical
L8330 0 3 Date of Service Edit: Clinical
L8400 0 3 Date of Service Edit: Clinical
L8410 0 3 Date of Service Edit: Clinical
L8415 0 3 Date of Service Edit: Clinical
L8417 0 3 Date of Service Edit: Clinical
L8420 0 3 Date of Service Edit: Clinical
L8430 0 3 Date of Service Edit: Clinical
L8435 0 3 Date of Service Edit: Clinical
L8440 0 3 Date of Service Edit: Clinical
L8460 0 3 Date of Service Edit: Clinical
L8465 0 3 Date of Service Edit: Clinical
L8470 0 3 Date of Service Edit: Clinical
L8480 0 3 Date of Service Edit: Clinical
L8485 0 3 Date of Service Edit: Clinical
L8500 0 3 Date of Service Edit: Clinical
HCPCS/CPT Code
Practitioner Services
MUE ValuesMUE Adjudication
IndicatorL8501 0 3 Date of Service Edit: Clinical
L8507 0 3 Date of Service Edit: Clinical
L8509 1 1 Line Edit
L8510 0 3 Date of Service Edit: Clinical
L8511 1 1 Line Edit
L8514 1 1 Line Edit
L8515 1 1 Line Edit
L8600 2 1 Line Edit
L8604 3 1 Line Edit
L8605 4 3 Date of Service Edit: Clinical
L8606 5 3 Date of Service Edit: Clinical
L8609 1 1 Line Edit
L8610 2 1 Line Edit
L8612 2 1 Line Edit
L8613 2 1 Line Edit
L8614 2 1 Line Edit
L8615 2 1 Line Edit
L8616 2 1 Line Edit
L8617 2 1 Line Edit
L8618 2 1 Line Edit
L8619 2 1 Line Edit
L8621 600 3 Date of Service Edit: Clinical
L8622 2 1 Line Edit
L8627 2 2 Date of Service Edit: Policy
L8628 2 2 Date of Service Edit: Policy
L8629 2 2 Date of Service Edit: Policy
L8631 4 1 Line Edit
L8641 4 1 Line Edit
L8642 2 1 Line Edit
L8658 4 1 Line Edit
L8659 4 1 Line Edit
L8670 4 1 Line Edit
L8679 3 3 Date of Service Edit: Clinical
L8681 1 1 Line Edit
L8682 2 1 Line Edit
L8683 1 1 Line Edit
L8684 1 1 Line Edit
L8685 1 1 Line Edit
L8686 2 1 Line Edit
L8687 1 1 Line Edit
L8688 1 1 Line Edit
L8689 1 1 Line Edit
L8690 2 2 Date of Service Edit: Policy
L8691 1 3 Date of Service Edit: Clinical
24
PRACTITIONER EDITS2015 PR
ACTITIO
NER
/DM
E MU
E
HCPCS/CPT Code
Practitioner Services
MUE ValuesMUE Adjudication
IndicatorL8692 0 3 Date of Service Edit: Clinical
L8693 1 3 Date of Service Edit: Clinical
L8695 1 1 Line Edit
M0064 1 2 Date of Service Edit: Policy
P2028 1 1 Line Edit
P2029 1 1 Line Edit
P2033 1 1 Line Edit
P2038 1 1 Line Edit
P3000 1 3 Date of Service Edit: Clinical
P3001 1 3 Date of Service Edit: Clinical
P9041 5 3 Date of Service Edit: Clinical
P9043 5 3 Date of Service Edit: Clinical
P9045 20 3 Date of Service Edit: Clinical
P9046 25 3 Date of Service Edit: Clinical
P9047 20 3 Date of Service Edit: Clinical
P9048 1 3 Date of Service Edit: Clinical
P9612 1 3 Date of Service Edit: Clinical
P9615 1 3 Date of Service Edit: Clinical
Q0035 1 1 Line Edit
Q0091 1 1 Line Edit
Q0111 2 1 Line Edit
Q0112 3 1 Line Edit
Q0113 2 1 Line Edit
Q0114 1 1 Line Edit
Q0115 1 1 Line Edit
Q0144 0 3 Date of Service Edit: Clinical
Q0161 0 3 Date of Service Edit: Clinical
Q0478 1 1 Line Edit
Q0479 1 1 Line Edit
Q0480 1 1 Line Edit
Q0481 1 2 Date of Service Edit: Policy
Q0482 1 1 Line Edit
Q0483 1 1 Line Edit
Q0484 1 1 Line Edit
Q0485 1 1 Line Edit
Q0486 1 1 Line Edit
Q0487 1 1 Line Edit
Q0488 1 1 Line Edit
Q0489 1 1 Line Edit
Q0490 1 1 Line Edit
Q0491 1 1 Line Edit
Q0492 1 1 Line Edit
Q0493 1 1 Line Edit
Q0494 1 1 Line Edit
HCPCS/CPT Code
Practitioner Services
MUE ValuesMUE Adjudication
IndicatorQ0495 1 1 Line Edit
Q0497 2 1 Line Edit
Q0498 1 1 Line Edit
Q0499 1 1 Line Edit
Q0501 1 1 Line Edit
Q0502 1 1 Line Edit
Q0503 3 1 Line Edit
Q0504 1 1 Line Edit
Q0507 1 3 Date of Service Edit: Clinical
Q0508 1 3 Date of Service Edit: Clinical
Q0509 1 3 Date of Service Edit: Clinical
Q0510 0 3 Date of Service Edit: Clinical
Q0511 0 3 Date of Service Edit: Clinical
Q0512 0 3 Date of Service Edit: Clinical
Q0513 0 3 Date of Service Edit: Clinical
Q0514 0 3 Date of Service Edit: Clinical
Q1004 2 1 Line Edit
Q1005 2 1 Line Edit
Q2004 1 3 Date of Service Edit: Clinical
Q2028 1470 3 Date of Service Edit: Clinical
Q2034 1 1 Line Edit
Q2035 1 2 Date of Service Edit: Policy
Q2036 1 2 Date of Service Edit: Policy
Q2037 1 2 Date of Service Edit: Policy
Q2038 1 2 Date of Service Edit: Policy
Q2039 1 2 Date of Service Edit: Policy
Q2043 1 1 Line Edit
Q2050 14 3 Date of Service Edit: Clinical
Q2052 1 3 Date of Service Edit: Clinical
Q3014 1 3 Date of Service Edit: Clinical
Q3027 30 3 Date of Service Edit: Clinical
Q3028 0 3 Date of Service Edit: Clinical
Q4001 1 1 Line Edit
Q4002 1 1 Line Edit
Q4003 2 1 Line Edit
Q4004 2 1 Line Edit
Q4025 1 1 Line Edit
Q4026 1 1 Line Edit
Q4027 1 1 Line Edit
Q4028 1 1 Line Edit
Q4074 3 3 Date of Service Edit: Clinical
Q4101 88 3 Date of Service Edit: Clinical
Q4102 21 3 Date of Service Edit: Clinical
Q4103 0 3 Date of Service Edit: Clinical
25
2015 HCPCS: LEVEL II NATIONAL CODES20
15 P
RA
CTIT
ION
ER/D
ME
MU
E
HCPCS/CPT Code
Practitioner Services
MUE ValuesMUE Adjudication
IndicatorQ4104 50 3 Date of Service Edit: Clinical
Q4105 250 3 Date of Service Edit: Clinical
Q4106 76 3 Date of Service Edit: Clinical
Q4107 50 3 Date of Service Edit: Clinical
Q4108 250 3 Date of Service Edit: Clinical
Q4110 250 3 Date of Service Edit: Clinical
Q4111 56 3 Date of Service Edit: Clinical
Q4112 2 3 Date of Service Edit: Clinical
Q4113 4 3 Date of Service Edit: Clinical
Q4114 6 3 Date of Service Edit: Clinical
Q4115 240 3 Date of Service Edit: Clinical
Q4116 192 3 Date of Service Edit: Clinical
Q4117 0 3 Date of Service Edit: Clinical
Q4118 1000 3 Date of Service Edit: Clinical
Q4119 150 3 Date of Service Edit: Clinical
Q4120 0 3 Date of Service Edit: Clinical
Q4121 78 3 Date of Service Edit: Clinical
Q4122 96 3 Date of Service Edit: Clinical
Q4123 160 3 Date of Service Edit: Clinical
Q4124 140 3 Date of Service Edit: Clinical
Q4125 28 3 Date of Service Edit: Clinical
Q4126 32 3 Date of Service Edit: Clinical
Q4127 100 3 Date of Service Edit: Clinical
Q4128 128 3 Date of Service Edit: Clinical
Q4129 81 3 Date of Service Edit: Clinical
Q4130 100 3 Date of Service Edit: Clinical
Q4131 49 3 Date of Service Edit: Clinical
Q4132 50 3 Date of Service Edit: Clinical
Q4133 113 3 Date of Service Edit: Clinical
Q4134 160 3 Date of Service Edit: Clinical
Q4135 900 3 Date of Service Edit: Clinical
Q4136 900 3 Date of Service Edit: Clinical
Q9955 10 2 Date of Service Edit: Policy
R0070 2 1 Line Edit
R0075 2 1 Line Edit
V2020 0 3 Date of Service Edit: Clinical
V2100 0 3 Date of Service Edit: Clinical
V2101 0 3 Date of Service Edit: Clinical
V2102 0 3 Date of Service Edit: Clinical
V2103 0 3 Date of Service Edit: Clinical
V2104 0 3 Date of Service Edit: Clinical
V2105 0 3 Date of Service Edit: Clinical
V2106 0 3 Date of Service Edit: Clinical
V2107 0 3 Date of Service Edit: Clinical
HCPCS/CPT Code
Practitioner Services
MUE ValuesMUE Adjudication
IndicatorV2108 0 3 Date of Service Edit: Clinical
V2109 0 3 Date of Service Edit: Clinical
V2110 0 3 Date of Service Edit: Clinical
V2111 0 3 Date of Service Edit: Clinical
V2112 0 3 Date of Service Edit: Clinical
V2113 0 3 Date of Service Edit: Clinical
V2114 0 3 Date of Service Edit: Clinical
V2115 0 3 Date of Service Edit: Clinical
V2118 0 3 Date of Service Edit: Clinical
V2121 0 3 Date of Service Edit: Clinical
V2199 2 3 Date of Service Edit: Clinical
V2200 0 3 Date of Service Edit: Clinical
V2201 0 3 Date of Service Edit: Clinical
V2202 0 3 Date of Service Edit: Clinical
V2203 0 3 Date of Service Edit: Clinical
V2204 0 3 Date of Service Edit: Clinical
V2205 0 3 Date of Service Edit: Clinical
V2206 0 3 Date of Service Edit: Clinical
V2207 0 3 Date of Service Edit: Clinical
V2208 0 3 Date of Service Edit: Clinical
V2209 0 3 Date of Service Edit: Clinical
V2210 0 3 Date of Service Edit: Clinical
V2211 0 3 Date of Service Edit: Clinical
V2212 0 3 Date of Service Edit: Clinical
V2213 0 3 Date of Service Edit: Clinical
V2214 0 3 Date of Service Edit: Clinical
V2215 0 3 Date of Service Edit: Clinical
V2218 0 3 Date of Service Edit: Clinical
V2219 0 3 Date of Service Edit: Clinical
V2220 0 3 Date of Service Edit: Clinical
V2221 0 3 Date of Service Edit: Clinical
V2299 0 3 Date of Service Edit: Clinical
V2300 0 3 Date of Service Edit: Clinical
V2301 0 3 Date of Service Edit: Clinical
V2302 0 3 Date of Service Edit: Clinical
V2303 0 3 Date of Service Edit: Clinical
V2304 0 3 Date of Service Edit: Clinical
V2305 0 3 Date of Service Edit: Clinical
V2306 0 3 Date of Service Edit: Clinical
V2307 0 3 Date of Service Edit: Clinical
V2308 0 3 Date of Service Edit: Clinical
V2309 0 3 Date of Service Edit: Clinical
V2310 0 3 Date of Service Edit: Clinical
V2311 0 3 Date of Service Edit: Clinical
26
PRACTITIONER EDITS2015 PR
ACTITIO
NER
/DM
E MU
E
HCPCS/CPT Code
Practitioner Services
MUE ValuesMUE Adjudication
IndicatorV2312 0 3 Date of Service Edit: Clinical
V2313 0 3 Date of Service Edit: Clinical
V2314 0 3 Date of Service Edit: Clinical
V2315 0 3 Date of Service Edit: Clinical
V2318 0 3 Date of Service Edit: Clinical
V2319 0 3 Date of Service Edit: Clinical
V2320 0 3 Date of Service Edit: Clinical
V2321 0 3 Date of Service Edit: Clinical
V2399 0 3 Date of Service Edit: Clinical
V2410 0 3 Date of Service Edit: Clinical
V2430 0 3 Date of Service Edit: Clinical
V2499 2 3 Date of Service Edit: Clinical
V2500 0 3 Date of Service Edit: Clinical
V2501 0 3 Date of Service Edit: Clinical
V2502 0 3 Date of Service Edit: Clinical
V2503 0 3 Date of Service Edit: Clinical
V2510 0 3 Date of Service Edit: Clinical
V2511 0 3 Date of Service Edit: Clinical
V2512 0 3 Date of Service Edit: Clinical
V2513 0 3 Date of Service Edit: Clinical
V2520 2 1 Line Edit
V2521 2 1 Line Edit
V2522 2 1 Line Edit
V2523 2 1 Line Edit
V2530 0 3 Date of Service Edit: Clinical
V2531 0 3 Date of Service Edit: Clinical
V2599 2 3 Date of Service Edit: Clinical
V2600 0 3 Date of Service Edit: Clinical
V2610 0 3 Date of Service Edit: Clinical
V2615 0 3 Date of Service Edit: Clinical
V2623 0 3 Date of Service Edit: Clinical
V2624 0 3 Date of Service Edit: Clinical
V2625 0 3 Date of Service Edit: Clinical
V2626 0 3 Date of Service Edit: Clinical
V2627 0 3 Date of Service Edit: Clinical
V2628 0 3 Date of Service Edit: Clinical
HCPCS/CPT Code
Practitioner Services
MUE ValuesMUE Adjudication
IndicatorV2629 0 3 Date of Service Edit: Clinical
V2630 2 1 Line Edit
V2631 2 1 Line Edit
V2632 2 1 Line Edit
V2700 0 3 Date of Service Edit: Clinical
V2710 0 3 Date of Service Edit: Clinical
V2715 0 3 Date of Service Edit: Clinical
V2718 0 3 Date of Service Edit: Clinical
V2730 0 3 Date of Service Edit: Clinical
V2744 0 3 Date of Service Edit: Clinical
V2745 0 3 Date of Service Edit: Clinical
V2750 0 3 Date of Service Edit: Clinical
V2755 0 3 Date of Service Edit: Clinical
V2761 0 3 Date of Service Edit: Clinical
V2770 0 3 Date of Service Edit: Clinical
V2780 0 3 Date of Service Edit: Clinical
V2781 0 3 Date of Service Edit: Clinical
V2782 0 3 Date of Service Edit: Clinical
V2783 0 3 Date of Service Edit: Clinical
V2784 0 3 Date of Service Edit: Clinical
V2785 2 1 Line Edit
V2790 1 1 Line Edit
V2797 0 3 Date of Service Edit: Clinical
V5008 0 1 Line Edit
V5010 0 1 Line Edit
V5011 0 1 Line Edit
V5274 0 3 Date of Service Edit: Clinical
V5281 0 1 Line Edit
V5282 0 1 Line Edit
V5284 0 1 Line Edit
V5285 0 1 Line Edit
V5286 0 1 Line Edit
V5287 0 1 Line Edit
V5288 0 1 Line Edit
V5289 0 1 Line Edit