2nd Quarter 2017

2065 Pages·2017·7.01 MB·English

Claim Editing Update Report: 2nd Quarter 2017
Page Section
1 McKesson Code Pair Additions
Code pair edits added to the McKesson KnowledgePack Update. Site-specific modifier override indicators for denied/paid code combination. Y = does override; N = does not override;
N/A = does not apply to the code combination.
12 McKesson Code Pair Rationale Descriptions
Rationale descriptions for the rationale codes included in the McKesson Code Pair Additions section.
33 McKesson Code Pair Expirations
Code pair edits closed from the McKesson KnowledgePack Update.
45 CCI V23.1 Additions
Edits added in new version of CCI. Provides brief CCI policy for each edit.
1,046 CCI V23.1 Expirations
Edits that were closed in new version of CCI.
1,048 CCI V23.1 Changes
Changes to modifier overrides (new override = 1 or no longer overrides = 0) for existing code pairs and changes to existing edits' effective and/or expiration date.
1,052 CCI V23.1 Deletions
Edits that were deleted in new version of CCI.
1,053 OCE CCI V23.1 Additions
Edits added in new version of OCE/CCI.
2,054 OCE CCI V23.1 Expirations
Edits that were closed in new version of OCE/CCI.
2,061 OCE CCI V23.1 Changes
Changes to modifier overrides (new override = 1 or no longer overrides = 0) for existing code pairs and changes to existing edits' effective and/or expiration date.
2,063 OCE CCI V23.1 Deletions
Edits that were deleted in new version of OCE/CCI.
An independent licensee of the
Blue Cross and Blue Shield Association
Instructions
PLEASE REVIEW THE FOLLOWING IMPORTANT INFORMATION
The information contained in this report is intended to expedite review of Horizon BCBSNJ 2016 3rd quarter edit changes. Edits in the workbook are sorted first by denied code then by paid code in ascending numeric order. A '#' sign immediately
Edit source abbreviations are defined below.
CCI Edits: CCI code pair edits are code pairs that should not be reported together for a number of reasons explained in the “National Correct Coding Initiative Coding Policy Manual for Medicare Services”. The CCI Additions tab contains new edits
added by CCI (with policy statement). The CCI Expirations tab contains edits expired by CCI. The CCI Deletions tab contains edits deleted by CCI. The CCI Changes tab contains edits modified by CCI. Changes can include 1) Modifier Override (CCI
"GB Indicator") modifications represented with a 'Modified' record and an 'Added' record, or 2) edit effective or expiration date modifications represented in one 'Modified' record. NOTE: An indicator of "1" = a modifier indicated by CCI can be used to
allow payment for both codes. "0" = No modifier can be used to bypass the edit pair.
OCE/CCI Edits: CCI edits incorporated into Outpatient Code Editor (OCE). The OCE/CCI Additions tab contains new edits added by OCE/CCI (with policy statement). The OCE/CCI Expirations tab contains edits expired by OCE/CCI. The CCI
Deletions tab contains edits deleted by OCE/CCI. The OCE/CCI Changes tab contains edits modified by OCE/CCI. Changes can include 1) Modifier Override (OCE/CCI "GB Indicator") modifications represented with a 'Modified' record and an 'Added'
record, or 2) edit effective or expiration date modifications represented in one 'Modified' record. NOTE: An indicator of "1" = a modifier indicated by OCE/CCI can be used to allow payment for both codes. "0" = No modifier can be used to bypass the
edit pair.
McKesson Code Pairs: This includes code pairs based on three of the rule types in the CXT UNBUN_PAIRS rule. These rule types are Incidental (INC), Mutually Exclusive (ME), and Parent/Child (ULT_PARENT) editing. An Edit Rationale number
is provided with each McKesson Code Pair addition, which can be used to refer to the Edit Report Rationale worksheet where they are listed in numeric order. This Edit Rationale number is specific to this report only.
General Modifier Information: Modifiers -25, -57, and -59 are intended to indicate that a service/procedure that would normally be included in payment for another service/procedure should, for specific reasons, not be denied when submitted with
one of these modifiers.
By default, modifier -25 will override any edit within the McKesson Code Pair Additions tab where the RULE_TYPE is ME or INC as well as any edit described in the McKesson Visits tab.
By default, modifier -57 will override any edit described in the McKesson Visits tab.
By default, modifier -59 will override any edit within the McKesson Code Pair Additions tab where the RULE_TYPE is ME, INC, or ULT_PARENT."
Source Abbreviation Source Name Source Abbreviation Source Name
AAOS American Academy of Orothopaedic Surgeons AUA American Urological Association.
ACC American College of Cardiology. CCI Correct Coding Initiative .
ACOG American College of Obstetricians and Gynecologists. CCN External physician consultants.
ACR American College of Radiology. CMS Centers for Medicare and Medicaid Services (CMS) coding guidelines.
ACS American College of Surgeons DMEPOS DME Prosthetic, Orthotic, Supplies Fee Schedule
AMA CPT coding guidelines. HPP Health Plan Policy
AMA RBRVS AMA RBRVS Data Manager PPP Internal physicians.
ASA American Society of Anesthesiologists. SMFM Society for Maternal-Fetal Medicine.
ASM American Society for Microbiology. STS Society of Thoracic Surgeons.
ClaimsXten™ is a trademark of McKesson Corporation.
CPT copyright 2017 American Medical Association. All rights reserved
All other product and company names may be trademarks or registered trademarks of their respective companies.
McKesson Code Pair Additions
Rule Denied Denied Code Paid Paid Code Rationale Horizon Revised
Type Code Description Code Description Code Effective Date
ME 0468T RMVL CHWAL RESPIR ELTRD/RA 0466T INSJ CHWAL RESPIR ELTRD/RA 137290 5/1/2017
INC 11043 DEB MUSC/FASCIA 20 SQ CM/< 15002 WOUND PREP TRK/ARM/LEG 137256 5/1/2017
INC 11043 DEB MUSC/FASCIA 20 SQ CM/< 15003 WOUND PREP ADDL 100 CM 137256 5/1/2017
INC 11043 DEB MUSC/FASCIA 20 SQ CM/< 15004 WOUND PREP F/N/HF/G 137256 5/1/2017
INC 11043 DEB MUSC/FASCIA 20 SQ CM/< 15005 WND PREP F/N/HF/G ADDL CM 137256 5/1/2017
INC 11044 DEB BONE 20 SQ CM/< 15002 WOUND PREP TRK/ARM/LEG 137256 5/1/2017
INC 11044 DEB BONE 20 SQ CM/< 15003 WOUND PREP ADDL 100 CM 137256 5/1/2017
INC 11044 DEB BONE 20 SQ CM/< 15004 WOUND PREP F/N/HF/G 137256 5/1/2017
INC 11044 DEB BONE 20 SQ CM/< 15005 WND PREP F/N/HF/G ADDL CM 137256 5/1/2017
INC 29805 SHOULDER ARTHROSCOPY DX 29806 SHOULDER ARTHROSCOPY/SURGERY 132118 5/1/2017
INC 29805 SHOULDER ARTHROSCOPY DX 29807 SHOULDER ARTHROSCOPY/SURGERY 125920 5/1/2017
INC 29805 SHOULDER ARTHROSCOPY DX 29819 SHOULDER ARTHROSCOPY/SURGERY 128303 5/1/2017
INC 29805 SHOULDER ARTHROSCOPY DX 29820 SHOULDER ARTHROSCOPY/SURGERY 137283 5/1/2017
INC 29805 SHOULDER ARTHROSCOPY DX 29821 SHOULDER ARTHROSCOPY/SURGERY 137283 5/1/2017
INC 29805 SHOULDER ARTHROSCOPY DX 29822 SHOULDER ARTHROSCOPY/SURGERY 126365 5/1/2017
INC 29805 SHOULDER ARTHROSCOPY DX 29823 SHOULDER ARTHROSCOPY/SURGERY 127994 5/1/2017
INC 29805 SHOULDER ARTHROSCOPY DX 29824 SHOULDER ARTHROSCOPY/SURGERY 5/1/2017
INC 29805 SHOULDER ARTHROSCOPY DX 29825 SHOULDER ARTHROSCOPY/SURGERY 5/1/2017
INC 29805 SHOULDER ARTHROSCOPY DX 29827 ARTHROSCOP ROTATOR CUFF REPR 126344 5/1/2017
INC 29805 SHOULDER ARTHROSCOPY DX 29828 ARTHROSCOPY BICEPS TENODESIS 129708 5/1/2017
INC 29830 ELBOW ARTHROSCOPY 29834 ELBOW ARTHROSCOPY/SURGERY 137282 5/1/2017
INC 29830 ELBOW ARTHROSCOPY 29835 ELBOW ARTHROSCOPY/SURGERY 137282 5/1/2017
INC 29830 ELBOW ARTHROSCOPY 29836 ELBOW ARTHROSCOPY/SURGERY 137282 5/1/2017
INC 29830 ELBOW ARTHROSCOPY 29837 ELBOW ARTHROSCOPY/SURGERY 137282 5/1/2017
INC 29830 ELBOW ARTHROSCOPY 29838 ELBOW ARTHROSCOPY/SURGERY 137282 5/1/2017
INC 29840 WRIST ARTHROSCOPY 29843 WRIST ARTHROSCOPY/SURGERY 5/1/2017
INC 29840 WRIST ARTHROSCOPY 29844 WRIST ARTHROSCOPY/SURGERY 5/1/2017
INC 29840 WRIST ARTHROSCOPY 29845 WRIST ARTHROSCOPY/SURGERY 5/1/2017
INC 29840 WRIST ARTHROSCOPY 29846 WRIST ARTHROSCOPY/SURGERY 127994 5/1/2017
INC 29840 WRIST ARTHROSCOPY 29847 WRIST ARTHROSCOPY/SURGERY 5/1/2017
INC 29860 HIP ARTHROSCOPY DX 29861 HIP ARTHRO W/FB REMOVAL 128936 5/1/2017
INC 29860 HIP ARTHROSCOPY DX 29862 HIP ARTHR0 W/DEBRIDEMENT 128936 5/1/2017
INC 29860 HIP ARTHROSCOPY DX 29863 HIP ARTHR0 W/SYNOVECTOMY 128936 5/1/2017
INC 29860 HIP ARTHROSCOPY DX 29914 HIP ARTHRO W/FEMOROPLASTY 132999 5/1/2017
INC 29860 HIP ARTHROSCOPY DX 29915 HIP ARTHRO ACETABULOPLASTY 132999 5/1/2017
INC 29860 HIP ARTHROSCOPY DX 29916 HIP ARTHRO W/LABRAL REPAIR 132999 5/1/2017
INC 29870 KNEE ARTHROSCOPY DX 29871 KNEE ARTHROSCOPY/DRAINAGE 136262 5/1/2017
INC 29870 KNEE ARTHROSCOPY DX 29873 KNEE ARTHROSCOPY/SURGERY 136262 5/1/2017
1
McKesson Code Pair Additions
Rule Denied Denied Code Paid Paid Code Rationale Horizon Revised
Type Code Description Code Description Code Effective Date
INC 29870 KNEE ARTHROSCOPY DX 29874 KNEE ARTHROSCOPY/SURGERY 124098 5/1/2017
INC 29870 KNEE ARTHROSCOPY DX 29875 KNEE ARTHROSCOPY/SURGERY 124103 5/1/2017
INC 29870 KNEE ARTHROSCOPY DX 29876 KNEE ARTHROSCOPY/SURGERY 135508 5/1/2017
INC 29870 KNEE ARTHROSCOPY DX 29877 KNEE ARTHROSCOPY/SURGERY 136065 5/1/2017
INC 29870 KNEE ARTHROSCOPY DX 29879 KNEE ARTHROSCOPY/SURGERY 128303 5/1/2017
INC 29870 KNEE ARTHROSCOPY DX 29880 KNEE ARTHROSCOPY/SURGERY 124403 5/1/2017
INC 29870 KNEE ARTHROSCOPY DX 29881 KNEE ARTHROSCOPY/SURGERY 124094 5/1/2017
INC 29870 KNEE ARTHROSCOPY DX 29882 KNEE ARTHROSCOPY/SURGERY 136262 5/1/2017
INC 29870 KNEE ARTHROSCOPY DX 29883 KNEE ARTHROSCOPY/SURGERY 136262 5/1/2017
INC 29870 KNEE ARTHROSCOPY DX 29884 KNEE ARTHROSCOPY/SURGERY 136262 5/1/2017
INC 29870 KNEE ARTHROSCOPY DX 29885 KNEE ARTHROSCOPY/SURGERY 131752 5/1/2017
INC 29870 KNEE ARTHROSCOPY DX 29886 KNEE ARTHROSCOPY/SURGERY 128303 5/1/2017
INC 29870 KNEE ARTHROSCOPY DX 29887 KNEE ARTHROSCOPY/SURGERY 136262 5/1/2017
INC 31505 DIAGNOSTIC LARYNGOSCOPY 31510 LARYNGOSCOPY WITH BIOPSY 122368 5/1/2017
INC 31505 DIAGNOSTIC LARYNGOSCOPY 31511 REMOVE FOREIGN BODY LARYNX 122368 5/1/2017
INC 31505 DIAGNOSTIC LARYNGOSCOPY 31512 REMOVAL OF LARYNX LESION 122368 5/1/2017
INC 31505 DIAGNOSTIC LARYNGOSCOPY 31513 INJECTION INTO VOCAL CORD 122368 5/1/2017
INC 31525 DX LARYNGOSCOPY EXCL NB 31527 LARYNGOSCOPY FOR TREATMENT 131070 5/1/2017
INC 31525 DX LARYNGOSCOPY EXCL NB 31528 LARYNGOSCOPY AND DILATION 131070 5/1/2017
INC 31525 DX LARYNGOSCOPY EXCL NB 31529 LARYNGOSCOPY AND DILATION 131070 5/1/2017
INC 31525 DX LARYNGOSCOPY EXCL NB 31530 LARYNGOSCOPY W/FB REMOVAL 131070 5/1/2017
INC 31525 DX LARYNGOSCOPY EXCL NB 31535 LARYNGOSCOPY W/BIOPSY 131070 5/1/2017
INC 31525 DX LARYNGOSCOPY EXCL NB 31540 LARYNGOSCOPY W/EXC OF TUMOR 131070 5/1/2017
INC 31525 DX LARYNGOSCOPY EXCL NB 31560 LARYNGOSCOP W/ARYTENOIDECTOM 131070 5/1/2017
INC 31525 DX LARYNGOSCOPY EXCL NB 31570 LARYNGOSCOPE W/VC INJ 131070 5/1/2017
INC 31526 DX LARYNGOSCOPY W/OPER SCOPE 31545 REMOVE VC LESION W/SCOPE 125714 5/1/2017
INC 31526 DX LARYNGOSCOPY W/OPER SCOPE 31546 REMOVE VC LESION SCOPE/GRAFT 125714 5/1/2017
INC 31575 DIAGNOSTIC LARYNGOSCOPY 31572 LARGSC W/LASER DSTRJ LES 137100 5/1/2017
INC 31575 DIAGNOSTIC LARYNGOSCOPY 31573 LARGSC W/THER INJECTION 137100 5/1/2017
INC 31575 DIAGNOSTIC LARYNGOSCOPY 31574 LARGSC W/NJX AUGMENTATION 137100 5/1/2017
INC 31575 DIAGNOSTIC LARYNGOSCOPY 31576 LARYNGOSCOPY WITH BIOPSY 129992 5/1/2017
INC 31575 DIAGNOSTIC LARYNGOSCOPY 31577 LARGSC W/RMVL FOREIGN BDY(S) 129992 5/1/2017
INC 31575 DIAGNOSTIC LARYNGOSCOPY 31578 LARGSC W/REMOVAL LESION 129992 5/1/2017
INC 31575 DIAGNOSTIC LARYNGOSCOPY 31579 LARYNGOSCOPY TELESCOPIC 129992 5/1/2017
INC 31622 DX BRONCHOSCOPE/WASH 31623 DX BRONCHOSCOPE/BRUSH 123653 5/1/2017
INC 31622 DX BRONCHOSCOPE/WASH 31624 DX BRONCHOSCOPE/LAVAGE 123688 5/1/2017
INC 31622 DX BRONCHOSCOPE/WASH 31625 BRONCHOSCOPY W/BIOPSY(S) 5/1/2017
INC 31622 DX BRONCHOSCOPE/WASH 31628 BRONCHOSCOPY/LUNG BX EACH 123652 5/1/2017
2
McKesson Code Pair Additions
Rule Denied Denied Code Paid Paid Code Rationale Horizon Revised
Type Code Description Code Description Code Effective Date
INC 31622 DX BRONCHOSCOPE/WASH 31629 BRONCHOSCOPY/NEEDLE BX EACH 123652 5/1/2017
INC 31622 DX BRONCHOSCOPE/WASH 31630 BRONCHOSCOPY DILATE/FX REPR 123662 5/1/2017
INC 31622 DX BRONCHOSCOPE/WASH 31631 BRONCHOSCOPY DILATE W/STENT 5/1/2017
INC 31622 DX BRONCHOSCOPE/WASH 31634 BRONCH W/BALLOON OCCLUSION 122399 5/1/2017
INC 31622 DX BRONCHOSCOPE/WASH 31635 BRONCHOSCOPY W/FB REMOVAL 5/1/2017
INC 31622 DX BRONCHOSCOPE/WASH 31636 BRONCHOSCOPY BRONCH STENTS 122399 5/1/2017
INC 31622 DX BRONCHOSCOPE/WASH 31638 BRONCHOSCOPY REVISE STENT 122399 5/1/2017
INC 31622 DX BRONCHOSCOPE/WASH 31640 BRONCHOSCOPY W/TUMOR EXCISE 5/1/2017
INC 31622 DX BRONCHOSCOPE/WASH 31641 BRONCHOSCOPY TREAT BLOCKAGE 5/1/2017
INC 31622 DX BRONCHOSCOPE/WASH 31645 BRONCHOSCOPY CLEAR AIRWAYS 128290 5/1/2017
INC 31622 DX BRONCHOSCOPE/WASH 31647 BRONCHIAL VALVE INIT INSERT 122399 5/1/2017
INC 31622 DX BRONCHOSCOPE/WASH 31648 BRONCHIAL VALVE REMOV INIT 122399 5/1/2017
INC 31622 DX BRONCHOSCOPE/WASH 31660 BRONCH THERMOPLSTY 1 LOBE 122399 5/1/2017
INC 31622 DX BRONCHOSCOPE/WASH 31661 BRONCH THERMOPLSTY 2/> LOBES 122399 5/1/2017
INC 43191 ESOPHAGOSCOPY RIGID TRNSO DX 43192 ESOPHAGOSCP RIG TRNSO INJECT 135496 5/1/2017
INC 43191 ESOPHAGOSCOPY RIGID TRNSO DX 43193 ESOPHAGOSCP RIG TRNSO BIOPSY 135496 5/1/2017
INC 43191 ESOPHAGOSCOPY RIGID TRNSO DX 43194 ESOPHAGOSCP RIG TRNSO REM FB 135496 5/1/2017
INC 43191 ESOPHAGOSCOPY RIGID TRNSO DX 43195 ESOPHAGOSCOPY RIGID BALLOON 135496 5/1/2017
INC 43191 ESOPHAGOSCOPY RIGID TRNSO DX 43196 ESOPHAGOSCP GUIDE WIRE DILAT 135496 5/1/2017
INC 43200 ESOPHAGOSCOPY FLEXIBLE BRUSH 43201 ESOPH SCOPE W/SUBMUCOUS INJ 123911 5/1/2017
INC 43200 ESOPHAGOSCOPY FLEXIBLE BRUSH 43202 ESOPHAGOSCOPY FLEX BIOPSY 135474 5/1/2017
INC 43200 ESOPHAGOSCOPY FLEXIBLE BRUSH 43204 ESOPH SCOPE W/SCLEROSIS INJ 135475 5/1/2017
INC 43200 ESOPHAGOSCOPY FLEXIBLE BRUSH 43205 ESOPHAGUS ENDOSCOPY/LIGATION 123911 5/1/2017
INC 43200 ESOPHAGOSCOPY FLEXIBLE BRUSH 43206 ESOPH OPTICAL ENDOMICROSCOPY 135495 5/1/2017
INC 43200 ESOPHAGOSCOPY FLEXIBLE BRUSH 43211 ESOPHAGOSCOP MUCOSAL RESECT 134694 5/1/2017
INC 43200 ESOPHAGOSCOPY FLEXIBLE BRUSH 43212 ESOPHAGOSCOP STENT PLACEMENT 134694 5/1/2017
INC 43200 ESOPHAGOSCOPY FLEXIBLE BRUSH 43213 ESOPHAGOSCOPY RETRO BALLOON 134694 5/1/2017
INC 43200 ESOPHAGOSCOPY FLEXIBLE BRUSH 43214 ESOPHAGOSC DILATE BALLOON 30 134694 5/1/2017
INC 43200 ESOPHAGOSCOPY FLEXIBLE BRUSH 43215 ESOPHAGOSCOPY FLEX REMOVE FB 135469 5/1/2017
INC 43200 ESOPHAGOSCOPY FLEXIBLE BRUSH 43216 ESOPHAGOSCOPY LESION REMOVAL 135476 5/1/2017
INC 43200 ESOPHAGOSCOPY FLEXIBLE BRUSH 43217 ESOPHAGOSCOPY SNARE LES REMV 135477 5/1/2017
INC 43200 ESOPHAGOSCOPY FLEXIBLE BRUSH 43220 ESOPHAGOSCOPY BALLOON <30MM 123911 5/1/2017
INC 43200 ESOPHAGOSCOPY FLEXIBLE BRUSH 43226 ESOPH ENDOSCOPY DILATION 123911 5/1/2017
INC 43200 ESOPHAGOSCOPY FLEXIBLE BRUSH 43227 ESOPHAGOSCOPY CONTROL BLEED 123911 5/1/2017
INC 43200 ESOPHAGOSCOPY FLEXIBLE BRUSH 43229 ESOPHAGOSCOPY LESION ABLATE 134694 5/1/2017
INC 43200 ESOPHAGOSCOPY FLEXIBLE BRUSH 43231 ESOPHAGOSCOP ULTRASOUND EXAM 123911 5/1/2017
INC 43200 ESOPHAGOSCOPY FLEXIBLE BRUSH 43232 ESOPHAGOSCOPY W/US NEEDLE BX 123911 5/1/2017
INC 43235 EGD DIAGNOSTIC BRUSH WASH 43210 EGD ESOPHAGOGASTRC FNDOPLSTY 136413 5/1/2017
3
McKesson Code Pair Additions
Rule Denied Denied Code Paid Paid Code Rationale Horizon Revised
Type Code Description Code Description Code Effective Date
INC 43235 EGD DIAGNOSTIC BRUSH WASH 43233 EGD BALLOON DIL ESOPH30 MM/> 122399 5/1/2017
INC 43235 EGD DIAGNOSTIC BRUSH WASH 43236 UPPR GI SCOPE W/SUBMUC INJ 123571 5/1/2017
INC 43235 EGD DIAGNOSTIC BRUSH WASH 43237 ENDOSCOPIC US EXAM ESOPH 123571 5/1/2017
INC 43235 EGD DIAGNOSTIC BRUSH WASH 43238 EGD US FINE NEEDLE BX/ASPIR 123571 5/1/2017
INC 43235 EGD DIAGNOSTIC BRUSH WASH 43239 EGD BIOPSY SINGLE/MULTIPLE 125687 5/1/2017
INC 43235 EGD DIAGNOSTIC BRUSH WASH 43240 EGD W/TRANSMURAL DRAIN CYST 122456 5/1/2017
INC 43235 EGD DIAGNOSTIC BRUSH WASH 43241 EGD TUBE/CATH INSERTION 122456 5/1/2017
INC 43235 EGD DIAGNOSTIC BRUSH WASH 43242 EGD US FINE NEEDLE BX/ASPIR 122456 5/1/2017
INC 43235 EGD DIAGNOSTIC BRUSH WASH 43243 EGD INJECTION VARICES 122456 5/1/2017
INC 43235 EGD DIAGNOSTIC BRUSH WASH 43244 EGD VARICES LIGATION 122456 5/1/2017
INC 43235 EGD DIAGNOSTIC BRUSH WASH 43245 EGD DILATE STRICTURE 122456 5/1/2017
INC 43235 EGD DIAGNOSTIC BRUSH WASH 43246 EGD PLACE GASTROSTOMY TUBE 122456 5/1/2017
INC 43235 EGD DIAGNOSTIC BRUSH WASH 43247 EGD REMOVE FOREIGN BODY 122456 5/1/2017
INC 43235 EGD DIAGNOSTIC BRUSH WASH 43248 EGD GUIDE WIRE INSERTION 122456 5/1/2017
INC 43235 EGD DIAGNOSTIC BRUSH WASH 43249 ESOPH EGD DILATION <30 MM 122456 5/1/2017
INC 43235 EGD DIAGNOSTIC BRUSH WASH 43250 EGD CAUTERY TUMOR POLYP 122431 5/1/2017
INC 43235 EGD DIAGNOSTIC BRUSH WASH 43251 EGD REMOVE LESION SNARE 122431 5/1/2017
INC 43235 EGD DIAGNOSTIC BRUSH WASH 43252 EGD OPTICAL ENDOMICROSCOPY 122368 5/1/2017
INC 43235 EGD DIAGNOSTIC BRUSH WASH 43253 EGD US TRANSMURAL INJXN/MARK 122399 5/1/2017
INC 43235 EGD DIAGNOSTIC BRUSH WASH 43254 EGD ENDO MUCOSAL RESECTION 122399 5/1/2017
INC 43235 EGD DIAGNOSTIC BRUSH WASH 43255 EGD CONTROL BLEEDING ANY 122431 5/1/2017
INC 43235 EGD DIAGNOSTIC BRUSH WASH 43257 EGD W/THRML TXMNT GERD 122399 5/1/2017
INC 43235 EGD DIAGNOSTIC BRUSH WASH 43259 EGD US EXAM DUODENUM/JEJUNUM 122431 5/1/2017
INC 43235 EGD DIAGNOSTIC BRUSH WASH 43266 EGD ENDOSCOPIC STENT PLACE 134936 5/1/2017
INC 43235 EGD DIAGNOSTIC BRUSH WASH 43270 EGD LESION ABLATION 122399 5/1/2017
INC 43260 ERCP W/SPECIMEN COLLECTION 43261 ENDO CHOLANGIOPANCREATOGRAPH 135456 5/1/2017
INC 43260 ERCP W/SPECIMEN COLLECTION 43262 ENDO CHOLANGIOPANCREATOGRAPH 135464 5/1/2017
INC 43260 ERCP W/SPECIMEN COLLECTION 43263 ERCP SPHINCTER PRESSURE MEAS 135456 5/1/2017
INC 43260 ERCP W/SPECIMEN COLLECTION 43264 ERCP REMOVE DUCT CALCULI 135456 5/1/2017
INC 43260 ERCP W/SPECIMEN COLLECTION 43265 ERCP LITHOTRIPSY CALCULI 135456 5/1/2017
INC 43260 ERCP W/SPECIMEN COLLECTION 43274 ERCP DUCT STENT PLACEMENT 135502 5/1/2017
INC 43260 ERCP W/SPECIMEN COLLECTION 43275 ERCP REMOVE FORGN BODY DUCT 135497 5/1/2017
INC 43260 ERCP W/SPECIMEN COLLECTION 43276 ERCP STENT EXCHANGE W/DILATE 135456 5/1/2017
INC 43260 ERCP W/SPECIMEN COLLECTION 43277 ERCP EA DUCT/AMPULLA DILATE 135456 5/1/2017
INC 43260 ERCP W/SPECIMEN COLLECTION 43278 ERCP LESION ABLATE W/DILATE 135456 5/1/2017
INC 44360 SMALL BOWEL ENDOSCOPY 44361 SMALL BOWEL ENDOSCOPY/BIOPSY 5/1/2017
INC 44360 SMALL BOWEL ENDOSCOPY 44363 SMALL BOWEL ENDOSCOPY 5/1/2017
INC 44360 SMALL BOWEL ENDOSCOPY 44364 SMALL BOWEL ENDOSCOPY 5/1/2017
4
McKesson Code Pair Additions
Rule Denied Denied Code Paid Paid Code Rationale Horizon Revised
Type Code Description Code Description Code Effective Date
INC 44360 SMALL BOWEL ENDOSCOPY 44365 SMALL BOWEL ENDOSCOPY 5/1/2017
INC 44360 SMALL BOWEL ENDOSCOPY 44366 SMALL BOWEL ENDOSCOPY 5/1/2017
INC 44360 SMALL BOWEL ENDOSCOPY 44369 SMALL BOWEL ENDOSCOPY 5/1/2017
INC 44360 SMALL BOWEL ENDOSCOPY 44370 SMALL BOWEL ENDOSCOPY/STENT 5/1/2017
INC 44360 SMALL BOWEL ENDOSCOPY 44373 SMALL BOWEL ENDOSCOPY 5/1/2017
INC 44376 SMALL BOWEL ENDOSCOPY 44377 SMALL BOWEL ENDOSCOPY/BIOPSY 5/1/2017
INC 44376 SMALL BOWEL ENDOSCOPY 44378 SMALL BOWEL ENDOSCOPY 5/1/2017
INC 44376 SMALL BOWEL ENDOSCOPY 44379 S BOWEL ENDOSCOPE W/STENT 5/1/2017
INC 44380 SMALL BOWEL ENDOSCOPY BR/WA 44381 SMALL BOWEL ENDOSCOPY BR/WA 135631 5/1/2017
INC 44380 SMALL BOWEL ENDOSCOPY BR/WA 44382 SMALL BOWEL ENDOSCOPY 135483 5/1/2017
INC 44380 SMALL BOWEL ENDOSCOPY BR/WA 44384 SMALL BOWEL ENDOSCOPY 135483 5/1/2017
INC 44388 COLONOSCOPY THRU STOMA SPX 44389 COLONOSCOPY WITH BIOPSY 135645 5/1/2017
INC 44388 COLONOSCOPY THRU STOMA SPX 44390 COLONOSCOPY FOR FOREIGN BODY 135645 5/1/2017
INC 44388 COLONOSCOPY THRU STOMA SPX 44391 COLONOSCOPY FOR BLEEDING 135645 5/1/2017
INC 44388 COLONOSCOPY THRU STOMA SPX 44392 COLONOSCOPY & POLYPECTOMY 135645 5/1/2017
INC 44388 COLONOSCOPY THRU STOMA SPX 44394 COLONOSCOPY W/SNARE 135645 5/1/2017
INC 44388 COLONOSCOPY THRU STOMA SPX 44401 COLONOSCOPY WITH ABLATION 135645 5/1/2017
INC 44388 COLONOSCOPY THRU STOMA SPX 44402 COLONOSCOPY W/STENT PLCMT 135645 5/1/2017
INC 44388 COLONOSCOPY THRU STOMA SPX 44403 COLONOSCOPY W/RESECTION 135645 5/1/2017
INC 44388 COLONOSCOPY THRU STOMA SPX 44404 COLONOSCOPY W/INJECTION 135645 5/1/2017
INC 44388 COLONOSCOPY THRU STOMA SPX 44405 COLONOSCOPY W/DILATION 135645 5/1/2017
INC 44388 COLONOSCOPY THRU STOMA SPX 44406 COLONOSCOPY W/ULTRASOUND 135645 5/1/2017
INC 44388 COLONOSCOPY THRU STOMA SPX 44407 COLONOSCOPY W/NDL ASPIR/BX 135645 5/1/2017
INC 44388 COLONOSCOPY THRU STOMA SPX 44408 COLONOSCOPY W/DECOMPRESSION 135645 5/1/2017
INC 45300 PROCTOSIGMOIDOSCOPY DX 45303 PROCTOSIGMOIDOSCOPY DILATE 122399 5/1/2017
INC 45300 PROCTOSIGMOIDOSCOPY DX 45305 PROCTOSIGMOIDOSCOPY W/BX 122399 5/1/2017
INC 45300 PROCTOSIGMOIDOSCOPY DX 45307 PROCTOSIGMOIDOSCOPY FB 122399 5/1/2017
INC 45300 PROCTOSIGMOIDOSCOPY DX 45308 PROCTOSIGMOIDOSCOPY REMOVAL 122399 5/1/2017
INC 45300 PROCTOSIGMOIDOSCOPY DX 45309 PROCTOSIGMOIDOSCOPY REMOVAL 122399 5/1/2017
INC 45300 PROCTOSIGMOIDOSCOPY DX 45315 PROCTOSIGMOIDOSCOPY REMOVAL 122399 5/1/2017
INC 45300 PROCTOSIGMOIDOSCOPY DX 45317 PROCTOSIGMOIDOSCOPY BLEED 122399 5/1/2017
INC 45300 PROCTOSIGMOIDOSCOPY DX 45320 PROCTOSIGMOIDOSCOPY ABLATE 122399 5/1/2017
INC 45300 PROCTOSIGMOIDOSCOPY DX 45321 PROCTOSIGMOIDOSCOPY VOLVUL 122399 5/1/2017
INC 45300 PROCTOSIGMOIDOSCOPY DX 45327 PROCTOSIGMOIDOSCOPY W/STENT 122399 5/1/2017
INC 45330 DIAGNOSTIC SIGMOIDOSCOPY 45331 SIGMOIDOSCOPY AND BIOPSY 135457 5/1/2017
INC 45330 DIAGNOSTIC SIGMOIDOSCOPY 45332 SIGMOIDOSCOPY W/FB REMOVAL 135457 5/1/2017
INC 45330 DIAGNOSTIC SIGMOIDOSCOPY 45333 SIGMOIDOSCOPY & POLYPECTOMY 135457 5/1/2017
INC 45330 DIAGNOSTIC SIGMOIDOSCOPY 45334 SIGMOIDOSCOPY FOR BLEEDING 135457 5/1/2017
5
McKesson Code Pair Additions
Rule Denied Denied Code Paid Paid Code Rationale Horizon Revised
Type Code Description Code Description Code Effective Date
INC 45330 DIAGNOSTIC SIGMOIDOSCOPY 45335 SIGMOIDOSCOPY W/SUBMUC INJ 135457 5/1/2017
INC 45330 DIAGNOSTIC SIGMOIDOSCOPY 45337 SIGMOIDOSCOPY & DECOMPRESS 135457 5/1/2017
INC 45330 DIAGNOSTIC SIGMOIDOSCOPY 45338 SIGMOIDOSCOPY W/TUMR REMOVE 135457 5/1/2017
INC 45330 DIAGNOSTIC SIGMOIDOSCOPY 45340 SIG W/TNDSC BALLOON DILATION 135457 5/1/2017
INC 45330 DIAGNOSTIC SIGMOIDOSCOPY 45341 SIGMOIDOSCOPY W/ULTRASOUND 135457 5/1/2017
INC 45330 DIAGNOSTIC SIGMOIDOSCOPY 45342 SIGMOIDOSCOPY W/US GUIDE BX 135457 5/1/2017
INC 45330 DIAGNOSTIC SIGMOIDOSCOPY 45346 SIGMOIDOSCOPY W/ABLATION 135864 5/1/2017
INC 45330 DIAGNOSTIC SIGMOIDOSCOPY 45347 SIGMOIDOSCOPY W/PLCMT STENT 135864 5/1/2017
INC 45330 DIAGNOSTIC SIGMOIDOSCOPY 45349 SIGMOIDOSCOPY W/RESECTION 135864 5/1/2017
INC 45330 DIAGNOSTIC SIGMOIDOSCOPY 45350 SGMDSC W/BAND LIGATION 135864 5/1/2017
INC 45378 DIAGNOSTIC COLONOSCOPY 45379 COLONOSCOPY W/FB REMOVAL 135459 5/1/2017
INC 45378 DIAGNOSTIC COLONOSCOPY 45380 COLONOSCOPY AND BIOPSY 135459 5/1/2017
INC 45378 DIAGNOSTIC COLONOSCOPY 45381 COLONOSCOPY SUBMUCOUS NJX 135459 5/1/2017
INC 45378 DIAGNOSTIC COLONOSCOPY 45382 COLONOSCOPY W/CONTROL BLEED 135459 5/1/2017
INC 45378 DIAGNOSTIC COLONOSCOPY 45384 COLONOSCOPY W/LESION REMOVAL 135459 5/1/2017
INC 45378 DIAGNOSTIC COLONOSCOPY 45385 COLONOSCOPY W/LESION REMOVAL 135459 5/1/2017
INC 45378 DIAGNOSTIC COLONOSCOPY 45386 COLONOSCOPY W/BALLOON DILAT 135459 5/1/2017
INC 45378 DIAGNOSTIC COLONOSCOPY 45388 COLONOSCOPY W/ABLATION 135459 5/1/2017
INC 45378 DIAGNOSTIC COLONOSCOPY 45389 COLONOSCOPY W/STENT PLCMT 135459 5/1/2017
INC 45378 DIAGNOSTIC COLONOSCOPY 45390 COLONOSCOPY W/RESECTION 135459 5/1/2017
INC 45378 DIAGNOSTIC COLONOSCOPY 45391 COLONOSCOPY W/ENDOSCOPE US 135459 5/1/2017
INC 45378 DIAGNOSTIC COLONOSCOPY 45392 COLONOSCOPY W/ENDOSCOPIC FNB 135459 5/1/2017
INC 45378 DIAGNOSTIC COLONOSCOPY 45393 COLONOSCOPY W/DECOMPRESSION 135459 5/1/2017
INC 45378 DIAGNOSTIC COLONOSCOPY 45398 COLONOSCOPY W/BAND LIGATION 135459 5/1/2017
INC 46600 DIAGNOSTIC ANOSCOPY SPX 46604 ANOSCOPY AND DILATION 122368 5/1/2017
INC 46600 DIAGNOSTIC ANOSCOPY SPX 46606 ANOSCOPY AND BIOPSY 122368 5/1/2017
INC 46600 DIAGNOSTIC ANOSCOPY SPX 46607 DIAGNOSTIC ANOSCOPY & BIOPSY 122368 5/1/2017
INC 46600 DIAGNOSTIC ANOSCOPY SPX 46608 ANOSCOPY REMOVE FOR BODY 122368 5/1/2017
INC 46600 DIAGNOSTIC ANOSCOPY SPX 46610 ANOSCOPY REMOVE LESION 122368 5/1/2017
INC 46600 DIAGNOSTIC ANOSCOPY SPX 46611 ANOSCOPY 122368 5/1/2017
INC 46600 DIAGNOSTIC ANOSCOPY SPX 46612 ANOSCOPY REMOVE LESIONS 122368 5/1/2017
INC 46600 DIAGNOSTIC ANOSCOPY SPX 46614 ANOSCOPY CONTROL BLEEDING 122368 5/1/2017
INC 46600 DIAGNOSTIC ANOSCOPY SPX 46615 ANOSCOPY 122368 5/1/2017
INC 47552 BILIARY ENDO PERQ DX W/SPECI 47553 BILIARY ENDOSCOPY THRU SKIN 122368 5/1/2017
INC 47552 BILIARY ENDO PERQ DX W/SPECI 47554 BILIARY ENDOSCOPY THRU SKIN 122368 5/1/2017
INC 47552 BILIARY ENDO PERQ DX W/SPECI 47555 BILIARY ENDOSCOPY THRU SKIN 122368 5/1/2017
INC 47552 BILIARY ENDO PERQ DX W/SPECI 47556 BILIARY ENDOSCOPY THRU SKIN 122368 5/1/2017
INC 49320 DIAG LAPARO SEPARATE PROC 38570 LAPAROSCOPY LYMPH NODE BIOP 122455 5/1/2017
6
McKesson Code Pair Additions
Rule Denied Denied Code Paid Paid Code Rationale Horizon Revised
Type Code Description Code Description Code Effective Date
INC 49320 DIAG LAPARO SEPARATE PROC 38571 LAPAROSCOPY LYMPHADENECTOMY 122455 5/1/2017
INC 49320 DIAG LAPARO SEPARATE PROC 38572 LAPAROSCOPY LYMPHADENECTOMY 122455 5/1/2017
INC 49320 DIAG LAPARO SEPARATE PROC 49321 LAPAROSCOPY BIOPSY 122455 5/1/2017
INC 49320 DIAG LAPARO SEPARATE PROC 49322 LAPAROSCOPY ASPIRATION 122455 5/1/2017
INC 49320 DIAG LAPARO SEPARATE PROC 49323 LAPARO DRAIN LYMPHOCELE 122455 5/1/2017
INC 49320 DIAG LAPARO SEPARATE PROC 49324 LAP INSERT TUNNEL IP CATH 122455 5/1/2017
INC 49320 DIAG LAPARO SEPARATE PROC 49325 LAP REVISION PERM IP CATH 122455 5/1/2017
INC 49320 DIAG LAPARO SEPARATE PROC 58541 LSH UTERUS 250 G OR LESS 128349 5/1/2017
INC 49320 DIAG LAPARO SEPARATE PROC 58550 LAPARO-ASST VAG HYSTERECTOMY 122455 5/1/2017
INC 49320 DIAG LAPARO SEPARATE PROC 58660 LAPAROSCOPY LYSIS 122455 5/1/2017
INC 49320 DIAG LAPARO SEPARATE PROC 58661 LAPAROSCOPY REMOVE ADNEXA 122455 5/1/2017
INC 49320 DIAG LAPARO SEPARATE PROC 58662 LAPAROSCOPY EXCISE LESIONS 122455 5/1/2017
INC 49320 DIAG LAPARO SEPARATE PROC 58670 LAPAROSCOPY TUBAL CAUTERY 122455 5/1/2017
INC 49320 DIAG LAPARO SEPARATE PROC 58671 LAPAROSCOPY TUBAL BLOCK 122455 5/1/2017
INC 49320 DIAG LAPARO SEPARATE PROC 58672 LAPAROSCOPY FIMBRIOPLASTY 122455 5/1/2017
INC 49320 DIAG LAPARO SEPARATE PROC 58673 LAPAROSCOPY SALPINGOSTOMY 122455 5/1/2017
INC 50551 KIDNEY ENDOSCOPY 50561 KIDNEY ENDOSCOPY & TREATMENT 127543 5/1/2017
INC 52000 CYSTOSCOPY 52001 CYSTOSCOPY REMOVAL OF CLOTS 134681 5/1/2017
INC 52000 CYSTOSCOPY 52005 CYSTOSCOPY & URETER CATHETER 122463 5/1/2017
INC 52000 CYSTOSCOPY 52007 CYSTOSCOPY AND BIOPSY 122463 5/1/2017
INC 52000 CYSTOSCOPY 52010 CYSTOSCOPY & DUCT CATHETER 122463 5/1/2017
INC 52000 CYSTOSCOPY 52204 CYSTOSCOPY W/BIOPSY(S) 122463 5/1/2017
INC 52000 CYSTOSCOPY 52214 CYSTOSCOPY AND TREATMENT 122463 5/1/2017
INC 52000 CYSTOSCOPY 52224 CYSTOSCOPY AND TREATMENT 122463 5/1/2017
INC 52000 CYSTOSCOPY 52234 CYSTOSCOPY AND TREATMENT 122463 5/1/2017
INC 52000 CYSTOSCOPY 52235 CYSTOSCOPY AND TREATMENT 122463 5/1/2017
INC 52000 CYSTOSCOPY 52240 CYSTOSCOPY AND TREATMENT 122463 5/1/2017
INC 52000 CYSTOSCOPY 52250 CYSTOSCOPY AND RADIOTRACER 122463 5/1/2017
INC 52000 CYSTOSCOPY 52260 CYSTOSCOPY AND TREATMENT 122463 5/1/2017
INC 52000 CYSTOSCOPY 52265 CYSTOSCOPY AND TREATMENT 122463 5/1/2017
INC 52000 CYSTOSCOPY 52270 CYSTOSCOPY & REVISE URETHRA 122463 5/1/2017
INC 52000 CYSTOSCOPY 52275 CYSTOSCOPY & REVISE URETHRA 122463 5/1/2017
INC 52000 CYSTOSCOPY 52276 CYSTOSCOPY AND TREATMENT 122463 5/1/2017
INC 52000 CYSTOSCOPY 52277 CYSTOSCOPY AND TREATMENT 122463 5/1/2017
INC 52000 CYSTOSCOPY 52281 CYSTOSCOPY AND TREATMENT 122368 5/1/2017
INC 52000 CYSTOSCOPY 52282 CYSTOSCOPY IMPLANT STENT 122463 5/1/2017
INC 52000 CYSTOSCOPY 52283 CYSTOSCOPY AND TREATMENT 122463 5/1/2017
INC 52000 CYSTOSCOPY 52285 CYSTOSCOPY AND TREATMENT 122463 5/1/2017
7
McKesson Code Pair Additions
Rule Denied Denied Code Paid Paid Code Rationale Horizon Revised
Type Code Description Code Description Code Effective Date
INC 52000 CYSTOSCOPY 52287 CYSTOSCOPY CHEMODENERVATION 122368 5/1/2017
INC 52000 CYSTOSCOPY 52290 CYSTOSCOPY AND TREATMENT 122463 5/1/2017
INC 52000 CYSTOSCOPY 52300 CYSTOSCOPY AND TREATMENT 122463 5/1/2017
INC 52000 CYSTOSCOPY 52301 CYSTOSCOPY AND TREATMENT 122463 5/1/2017
INC 52000 CYSTOSCOPY 52305 CYSTOSCOPY AND TREATMENT 122463 5/1/2017
INC 52000 CYSTOSCOPY 52310 CYSTOSCOPY AND TREATMENT 122463 5/1/2017
INC 52000 CYSTOSCOPY 52315 CYSTOSCOPY AND TREATMENT 122463 5/1/2017
INC 52000 CYSTOSCOPY 52317 REMOVE BLADDER STONE 122463 5/1/2017
INC 52000 CYSTOSCOPY 52318 REMOVE BLADDER STONE 122463 5/1/2017
INC 52000 CYSTOSCOPY 52320 CYSTOSCOPY AND TREATMENT 134682 5/1/2017
INC 52000 CYSTOSCOPY 52325 CYSTOSCOPY STONE REMOVAL 134683 5/1/2017
INC 52000 CYSTOSCOPY 52327 CYSTOSCOPY INJECT MATERIAL 134683 5/1/2017
INC 52000 CYSTOSCOPY 52330 CYSTOSCOPY AND TREATMENT 134683 5/1/2017
INC 52000 CYSTOSCOPY 52332 CYSTOSCOPY AND TREATMENT 134683 5/1/2017
INC 52000 CYSTOSCOPY 52334 CREATE PASSAGE TO KIDNEY 134684 5/1/2017
INC 52000 CYSTOSCOPY 52341 CYSTO W/URETER STRICTURE TX 134684 5/1/2017
INC 52000 CYSTOSCOPY 52342 CYSTO W/UP STRICTURE TX 134684 5/1/2017
INC 52000 CYSTOSCOPY 52343 CYSTO W/RENAL STRICTURE TX 134683 5/1/2017
INC 52000 CYSTOSCOPY 52344 CYSTO/URETERO STRICTURE TX 122463 5/1/2017
INC 52000 CYSTOSCOPY 52400 CYSTOURETERO W/CONGEN REPR 122463 5/1/2017
INC 52000 CYSTOSCOPY 52402 CYSTOURETHRO CUT EJACUL DUCT 122463 5/1/2017
INC 52351 CYSTOURETERO & OR PYELOSCOPE 52345 CYSTO/URETERO W/UP STRICTURE 135040 5/1/2017
INC 52351 CYSTOURETERO & OR PYELOSCOPE 52346 CYSTOURETERO W/RENAL STRICT 135040 5/1/2017
INC 52351 CYSTOURETERO & OR PYELOSCOPE 52352 CYSTOURETERO W/STONE REMOVE 134655 5/1/2017
INC 52351 CYSTOURETERO & OR PYELOSCOPE 52353 CYSTOURETERO W/LITHOTRIPSY 134655 5/1/2017
INC 52351 CYSTOURETERO & OR PYELOSCOPE 52354 CYSTOURETERO W/BIOPSY 134655 5/1/2017
INC 52351 CYSTOURETERO & OR PYELOSCOPE 52355 CYSTOURETERO W/EXCISE TUMOR 134655 5/1/2017
INC 52351 CYSTOURETERO & OR PYELOSCOPE 52356 CYSTO/URETERO W/LITHOTRIPSY 135040 5/1/2017
INC 58555 HYSTEROSCOPY DX SEP PROC 58558 HYSTEROSCOPY BIOPSY 128290 5/1/2017
INC 58555 HYSTEROSCOPY DX SEP PROC 58559 HYSTEROSCOPY LYSIS 5/1/2017
INC 58555 HYSTEROSCOPY DX SEP PROC 58560 HYSTEROSCOPY RESECT SEPTUM 5/1/2017
INC 58555 HYSTEROSCOPY DX SEP PROC 58561 HYSTEROSCOPY REMOVE MYOMA 5/1/2017
INC 58555 HYSTEROSCOPY DX SEP PROC 58562 HYSTEROSCOPY REMOVE FB 122399 5/1/2017
INC 58555 HYSTEROSCOPY DX SEP PROC 58563 HYSTEROSCOPY ABLATION 126730 5/1/2017
INC 58555 HYSTEROSCOPY DX SEP PROC 58565 HYSTEROSCOPY STERILIZATION 125676 5/1/2017
INC 63047 REMOVE SPINE LAMINA 1 LMBR 22633 LUMBAR SPINE FUSION COMBINED 137279 5/1/2017
INC 63047 REMOVE SPINE LAMINA 1 LMBR 22634 SPINE FUSION EXTRA SEGMENT 137279 5/1/2017
ME 65450 TREATMENT OF CORNEAL LESION 65400 REMOVAL OF EYE LESION 129194 5/1/2017
8