68.29 Other excision or destruction of lesion of uterus
Uterine myomectomy
Excludes: biopsy of uterus (68.13, 68.16)
uterine fistulectomy (69.42)
68.3 Subtotal abdominal hysterectomy
68.31 Laparoscopic supracervical hysterectomy [LSH]
Classic infrafascial SEMM hysterectomy [CISH]
Laparoscopically assisted supracervical hysterectomy [LASH]
68.39 Other and unspecified subtotal abdominal hysterectomy
Supracervical hysterectomy
Excludes:classic infrafascial SEMM hysterectomy [CISH] (68.31)
laparoscopic supracervical hysterectomy [LSH] (68.31)
68.4 Total abdominal hysterectomy
Code also any synchronous removal of tubes and ovaries (65.31-65.64)
Excludes: laparoscopic total abdominal hysterectomy (68.41)
radical abdominal hysterectomy, any approach (68.61 - 68.69)
68.41 Laparoscopic total abdominal hysterectomy
Total laparoscopic hysterectomy [TLH]
68.49 Other and unspecified total abdominal hysterectomy
Hysterectomy:
extended
68.5 Vaginal hysterectomy
Code also any synchronous:
removal of tubes and ovaries (65.31-65.64)
repair of cystocele or rectocele (70.50-70.52)
repair of pelvic floor (70.79)
68.51 Laparoscopically assisted vaginal hysterectomy (LAVH)
68.59 Other and unspecified vaginal hysterectomy
Excludes: laparoscopically assisted vaginal hysterectomy (LAVH) (68.51)
radical vaginal hysterectomy (68.7)
68.6 Radical abdominal hysterectomy
Code also any synchronous:
lymph gland dissection (40.3, 40.5)
removal of tubes and ovaries (65.31-65.64)
Excludes: pelvic evisceration (68.8)
68.61 Laparoscopic radical abdominal hysterectomy
Laparoscopic modified radical hysterectomy
Total laparoscopic radical hysterectomy [TLRH]
68.69 Other and unspecified radical abdominal hysterectomy
Modified radical hysterectomy
Wertheim's operation
Excludes: laparoscopic total abdominal hysterectomy (68.41)
laparoscopic radical abdominal hysterectomy (68.61)
68.7 Radical vaginal hysterectomy
Code also any synchronous:
lymph gland dissection (40.3, 40.5)
removal of tubes and ovaries (65.31-65.64)
Excludes: abdominal hysterectomy, any approach (68.31-68.39, 68.41-68.49, 68.61-68.69, 68.9)
68.71 Laparoscopic radical vaginal hysterectomy [LRVH]
68.79 Other and unspecified radical vaginal hysterectomy
Hysterocolpectomy
Schauta operation
68.8 Pelvic evisceration
Removal of ovaries, tubes, uterus, vagina, bladder, and urethra (with removal of sigmoid colon and rectum)
Code also any synchronous:
colostomy (46.12-46.13)
lymph gland dissection (40.3, 40.5)
urinary diversion (56.51-56.79)
68.9 Other and unspecified hysterectomy
Hysterectomy, NOS
Excludes: abdominal hysterectomy, any approach (68.31-68.39, 68.41-68.49, 68.61-68.69)
vaginal hysterectomy, any approach (68.51- 68.59, 68.71- 68.79)
69 Other operations on uterus and supporting structures
Code also any application or administration of an adhesion barrier substance (99.77)
69.0 Dilation and curettage of uterus
Excludes: aspiration curettage of uterus (69.51-69.59)
69.01 Dilation and curettage for termination of pregnancy
69.02 Dilation and curettage following delivery or abortion
69.09 Other dilation and curettage
Diagnostic D and C
69.1 Excision or destruction of lesion or tissue of uterus and supporting structures
69.19 Other excision or destruction of uterus and supporting structures
Excludes: biopsy of uterine ligamen (68.14)
69.2 Repair of uterine supporting structures
69.21 Interposition operation
Watkins procedure
69.22 Other uterine suspension
Hysteropexy
Manchester operation
Plication of uterine ligament
69.23 Vaginal repair of chronic inversion of uterus
69.29 Other repair of uterus and supporting structures
69.3 Paracervical uterine denervation
69.4 Uterine repair
Excludes: repair of current obstetric laceration (75.50-75.52)
69.41 Suture of laceration of uterus
69.42 Closure of fistula of uterus
Excludes: uterovesical fistulectom (57.84)
69.49 Other repair of uterus
Repair of old obstetric laceration of uterus
69.5 Aspiration curettage of uterus
Excludes: menstrual extraction (69.6)
69.51 Aspiration curettage of uterus for termination of pregnancy
Therapeutic abortion NOS
69.52 Aspiration curettage following delivery or abortion
69.59 Other aspiration curettage of uterus
69.6 Menstrual extraction or regulation
69.7 Insertion of intrauterine contraceptive device
69.9 Other operations on uterus, cervix, and supporting structures
Excludes: obstetric dilation or incision of cervix (73.1, 73.93)
69.91 Insertion of therapeutic device into uterus
Excludes: insertion of:
intrauterine contraceptive device (69.7)
laminaria (69.93)
obstetric insertion of bag, bougie, or pack (73.1)
69.92 Artificial insemination
69.93 Insertion of laminaria
69.94 Manual replacement of inverted uterus
Excludes: that in immediate postpartal period (75.94)
69.95 Incision of cervix
Excludes: that to assist delivery (73.93)
69.96 Removal of cerclage material from cervix
69.97 Removal of other penetrating foreign body from cervix
Excludes: removal of intraluminal foreign body from cervix (98.16)
69.98 Other operations on supporting structures of uterus
Excludes: biopsy of uterine ligamen (68.14)
69.99 Other operations on cervix and uterus
Excludes: removal of:
foreign body (98.16)
intrauterine contraceptive device (97.71)
obstetric bag, bougie, or pack (97.72)
packing (97.72)
70 Operations on vagina and cul-de-sac
Code also any application or administration of an adhesion barrier substance (99.77)
70.0 Culdocentesis
70.1 Incision of vagina and cul-de-sac
70.11 Hymenotomy
70.12 Culdotomy
70.13 Lysis of intraluminal adhesions of vagina
70.14 Other vaginotomy
Division of vaginal septum
Drainage of hematoma of vaginal cuff
70.2 Diagnostic procedures on vagina and cul-de-sac
70.21 Vaginoscopy
70.22 Culdoscopy
70.23 Biopsy of cul-de-sac
70.24 Vaginal biopsy
70.29 Other diagnostic procedures on vagina and cul- de-sac
70.3 Local excision or destruction of vagina and cul-de-sac
70.31 Hymenectomy
70.32 Excision or destruction of lesion of cul-de- sac
Endometrectomy of cul-de-sac
Excludes: biopsy of cul-de-sac (70.23)
70.33 Excision or destruction of lesion of vagina
Excludes: biopsy of vagina (70.24)
vaginal fistulectomy (70.72-70.75)
70.4 Obliteration and total excision of vagina
Vaginectomy
Excludes: obliteration of vaginal vault (70.8)
70.5 Repair of cystocele and rectocele
70.50 Repair of cystocele and rectocele
Excludes: repair of cystocele and rectocele with graft or prosthesis (70.53)
70.51 Repair of cystocele
Anterior colporrhaphy (with urethrocele repair)
Excludes: repair of cystocele and rectocele with graft or prosthesis (70.53)
repair of cystocele with graft or prosthesis (70.54)
70.52 Repair of rectocele
Posterior colporrhaphy
Excludes: repair of cystocele and rectocele with graft or prosthesis (70.53)
repair of rectocele wtih graft or prosthesis (70.55)
STARR procedure (48.74)
70.53 Repair of cystocele and rectocele with graft or prosthesis
Use additional code for biological substance (70.94) or synthetic substance (70.95), if known
70.54 Repair of cystocele with graft or prosthesis
Anterior colporrhaphy (with urethrocele repair)
Use additional code for biological substance (70.94) or synthetic substance (70.95), if known
70.55 Repair of rectocele with graft or prosthesis
Posterior colporrhaphy
Use additional code for biological substance (70.94) or synthetic substance (70.95), if known
70.6 Vaginal construction and reconstruction
70.61 Vaginal construction
70.62 Vaginal reconstruction
70.63 Vaginal construction with graft or prosthesis
Use additional code for biological substance (70.94) or synthetic substance (70.95), if known
Excludes: vaginal construction (70.61)
70.64 Vaginal reconstruction with graft or prosthesis
Use additional code for biological substance (70.94) or synthetic substance (70.95), if known
Excludes: vaginal reconstruction (70.62)
70.7 Other repair of vagina
Excludes: lysis of intraluminal adhesions (70.13)
repair of current obstetric laceration (75.69)
that associated with cervical amputation (67.4)
70.71 Suture of laceration of vagina
70.72 Repair of colovaginal fistula
70.73 Repair of rectovaginal fistula
70.74 Repair of other vaginoenteric fistula
70.75 Repair of other fistula of vagina
Excludes: repair of fistula:
rectovesicovaginal (57.83)
ureterovaginal (56.84)
urethrovaginal (58.43)
uterovaginal (69.42)
vesicocervicovaginal (57.84)
vesicosigmoidovaginal (57.83)
vesicoureterovaginal (56.84)
vesicovaginal (57.84)
70.76 Hymenorrhaphy
70.77 Vaginal suspension and fixation
70.78 Vaginal suspension and fixation with graft or prosthesis
Use additional code for biological substance (70.94) or synthetic substance (70.95), if known
70.79 Other repair of vagina
Colpoperineoplasty
Repair of old obstetric laceration of vagina
70.8 Obliteration of vaginal vault
LeFort operation
70.9 Other operations on vagina and cul-de-sac
70.91 Other operations on vagina
Excludes: insertion of:
diaphragm (96.17)
mold (96.15)
pack (96.14)
pessary (96.18)
suppository (96.49)
removal of:
diaphragm (97.73)
foreign body (98.17)
pack (97.75)
pessary (97.74)
replacement of:
diaphragm (97.24)
pack (97.26)
pessary (97.25)
vaginal dilation (96.16)
vaginal douche (96.44)
70.92 Other operations on cul-de-sac
Obliteration of cul-de-sac
Repair of vaginal enterocele
70.93 Other operations on cul-de-sac with graft or prosthesis
Repair of vaginal enterocele with graft or prosthesis
Use additional code for biological substance (70.94) or synthetic substance (70.95), if known
70.94 Insertion of biological graft
Allogenic material or substance
Allograft
Autograft
Autologous material or substance
Heterograft
Xenogenic material or substance
Code first these procedures when done with graft or prosthesis:
Other operations on cul-de-sac (70.93)
Repair of cystocele (70.54)
Repair of cystocele and rectocele (70.53)
Repair of rectocele (70.55)
Vaginal construction (70.63)
Vaginal reconstruction (70.64)
Vaginal suspension and fixation (70.78)
70.95 Insertion of synthetic graft or prosthesis
Artificial tissue
Code first these procedures when done with graft or prosthesis:
Other operations on cul-de-sac (70.93)
Repair of cystocele (70.54)
Repair of cystocele and rectocele (70.53)
Repair of rectocele (70.55)
Vaginal construction (70.63)
Vaginal reconstruction (70.64)
Vaginal suspension and fixation (70.78)
71 Operations on vulva and perineum
Code also any application or administration of an adhesion barrier substance (99.77)
71.0 Incision of vulva and perineum
71.01 Lysis of vulvar adhesions
71.09 Other incision of vulva and perineum
Enlargement of introitus NOS
Excludes: removal of foreign body without incision (98.23)
71.1 Diagnostic procedures on vulva
71.11 Biopsy of vulva
71.19 Other diagnostic procedures on vulva
71.2 Operations on Bartholin's gland
71.21 Percutaneous aspiration of Bartholin's gland (cyst)
71.22 Incision of Bartholin's gland (cyst)
71.23 Marsupialization of Bartholin's gland (cyst)
71.24 Excision or other destruction of Bartholin's gland (cyst)
71.29 Other operations on Bartholin's gland
71.3 Other local excision or destruction of vulva and perineum
Division of Skene's gland
Excludes: biopsy of vulva (71.11)
vulvar fistulectomy (71.72)
71.4 Operations on clitoris
Amputation of clitoris
Clitoridotomy
Female circumcision
71.5 Radical vulvectomy
Code also any synchronous lymph gland dissection (40.3, 40.5)
71.6 Other vulvectomy
71.61 Unilateral vulvectomy
71.62 Bilateral vulvectomy
Vulvectomy NOS
71.7 Repair of vulva and perineum
Excludes: repair of current obstetric laceration (75.69)
71.71 Suture of laceration of vulva or perineum
71.72 Repair of fistula of vulva or perineum
Excludes: repair of fistula:
urethroperineal (58.43)
urethroperineovesical (57.84)
vaginoperineal (70.75)
71.79 Other repair of vulva and perineum
Repair of old obstetric laceration of vulva or perineum
71.8 Other operations on vulva
Excludes: removal of:
foreign body without incision (98.23)
packing (97.75)
replacement of packing (97.26)
71.9 Other operations on female genital organs
13. OBSTETRICAL PROCEDURES (72-75)
72 Forceps, vacuum, and breech delivery
72.0 Low forceps operation
Outlet forceps operation
72.1 Low forceps operation with episiotomy
Outlet forceps operation with episiotomy
72.2 Mid forceps operation
72.21 Mid forceps operation with episiotomy
72.29 Other mid forceps operation
72.3 High forceps operation
72.31 High forceps operation with episiotomy
72.39 Other high forceps operation
72.4 Forceps rotation of fetal head
DeLee maneuver
Key-in-lock rotation
Kielland rotation
Scanzoni's maneuver
Code also any associated forceps extraction (72.0-72.39)
72.5 Breech extraction
72.51 Partial breech extraction with forceps to aftercoming head
72.52 Other partial breech extraction
72.53 Total breech extraction with forceps to aftercoming head
72.54 Other total breech extraction
72.6 Forceps application to aftercoming head
Piper forceps operation
Excludes: partial breech extraction with forceps to aftercoming head (72.51)
total breech extraction with forceps to aftercoming head (72.53)
72.7 Vacuum extraction
Includes: Malström's extraction
72.71 Vacuum extraction with episiotomy
72.79 Other vacuum extraction
72.8 Other specified instrumental delivery
72.9 Unspecified instrumental delivery
73 Other procedures inducing or assisting delivery
73.0 Artificial rupture of membranes
73.01 Induction of labor by artificial rupture of membranes
Surgical induction NOS
Excludes: artificial rupture of membranes after onset of labor (73.09)
73.09 Other artificial rupture of membranes
Artificial rupture of membranes at time of delivery
73.1 Other surgical induction of labor
Induction by cervical dilation
Excludes: injection for abortion (75.0)
insertion of suppository for abortion (96.49)
73.2 Internal and combined version and extraction
73.21 Internal and combined version without extraction
Version NOS
73.22 Internal and combined version with extraction
73.3 Failed forceps
Application of forceps without delivery
Trial forceps
73.4 Medical induction of labor
Excludes: medication to augment active labor -- omit code
73.5 Manually assisted delivery
73.51 Manual rotation of fetal head
73.59 Other manually assisted delivery
Assisted spontaneous delivery
Crede maneuver
73.6 Episiotomy
Episioproctotomy
Episiotomy with subsequent episiorrhaphy
Excludes: that with:
high forceps (72.31)
low forceps (72.1)
mid forceps (72.21)
outlet forceps (72.1)
vacuum extraction (72.71)
73.8 Operations on fetus to facilitate delivery
Clavicotomy on fetus
Destruction of fetus
Needling of hydrocephalic head
73.9 Other operations assisting delivery
73.91 External version
73.92 Replacement of prolapsed umbilical cord
73.93 Incision of cervix to assist delivery
Dührssen's incisions
73.94 Pubiotomy to assist delivery
Obstetrical symphysiotomy
73.99 Other
Excludes: dilation of cervix, obstetrical to induce labor (73.1)
insertion of bag or bougie to induce labor (73.1)
removal of cerclage material (69.96)
74 Cesarean section and removal of fetus
Code also any synchronous:
hysterectomy (68.3-68.4, 68.6, 68.8)
myomectomy (68.29)
sterilization (66.31-66.39, 66.63)
74.0 Classical cesarean section
Transperitoneal classical cesarean section
74.1 Low cervical cesarean section
Lower uterine segment cesarean section
74.2 Extraperitoneal cesarean section
Supravesical cesarean section
74.3 Removal of extratubal ectopic pregnancy
Removal of:
ectopic abdominal pregnancy
fetus from peritoneal or extraperitoneal cavity following uterine or tubal rupture
Excludes: that by salpingostomy (66.02)
that by salpingotomy (66.01)
that with synchronous salpingectomy (66.62)
74.4 Cesarean section of other specified type
Peritoneal exclusion cesarean section
Transperitoneal cesarean section NOS
Vaginal cesarean section
74.9 Cesarean section of unspecified type
74.91 Hysterotomy to terminate pregnancy
Therapeutic abortion by hysterotomy
74.99 Other cesarean section of unspecified type
Cesarean section NOS
Obstetrical abdominouterotomy
Obstetrical hysterotomy
75 Other obstetric operations
75.0 Intra-amniotic injection for abortion
Injection of:
prostaglandin for induction of abortion
saline for induction of abortion
Termination of pregnancy by intrauterine injection
Excludes: insertion of prostaglandin suppository for abortion (96.49)
75.1 Diagnostic amniocentesis
75.2 Intrauterine transfusion
Exchange transfusion in utero
Insertion of catheter into abdomen of fetus for transfusion
Code also any hysterotomy approach (68.0)
75.3 Other intrauterine operations on fetus and amnion
Code also any hysterotomy approach (68.0)
75.31 Amnioscopy
Fetoscopy
Laparoamnioscopy
75.32 Fetal EKG (scalp)
75.33 Fetal blood sampling and biopsy
75.34 Other fetal monitoring
Antepartum fetal nonstress test
Fetal monitoring, not otherwise specified
Excludes: fetal pulse oximetry (75.38)
75.35 Other diagnostic procedures on fetus and amnion
Intrauterine pressure determination
Excludes: amniocentesis (75.1)
diagnostic procedures on gravid uterus and placenta (87.81, 88.46, 88.78, 92.17)
75.36 Correction of fetal defect
75.37 Amnioinfusion
Code also injection of antibiotic (99.21)
75.38 Fetal pulse oximetry
Transcervical fetal oxygen saturation monitoring
Transcervical fetal SpO2 monitoring
75.4 Manual removal of retained placenta
Excludes: aspiration curettage (69.52)
dilation and curettage (69.02)
75.5 Repair of current obstetric laceration of uterus
75.50 Repair of current obstetric laceration of uterus, not otherwise specified
75.51 Repair of current obstetric laceration of cervix
75.52 Repair of current obstetric laceration of corpus uteri
75.6 Repair of other current obstetric laceration
Code also episiotomy, if performed (73.6)
75.61 Repair of current obstetric laceration of bladder and urethra
75.62 Repair of current obstetric laceration of rectum and sphincter ani
75.69 Repair of other current obstetric laceration
Episioperineorrhaphy
Repair of:
pelvic floor
perineum
vagina
vulva
Secondary repair of episiotomy
75.7 Manual exploration of uterine cavity, postpartum
75.8 Obstetric tamponade of uterus or vagina
Excludes: antepartum tamponade (73.1)
75.9 Other obstetric operations
75.91 Evacuation of obstetrical incisional hematoma of perineum
Evacuation of hematoma of:
episiotomy perineorrhaphy
75.92 Evacuation of other hematoma of vulva or vagina
75.93 Surgical correction of inverted uterus
Spintelli operation
Excludes: vaginal repair of chronic inversion of uterus (69.23)
75.94 Manual replacement of inverted uterus
75.99 Other
14. OPERATIONS ON THE MUSCULOSKELETAL SYSTEM (76-84)
76 Operations on facial bones and joints
Excludes: accessory sinuses (22.00-22.9)
nasal bones (21.00-21.99)
skull (01.01-02.99)
76.0 Incision of facial bone without division
76.01 Sequestrectomy of facial bone
Removal of necrotic bone chip from facial bone
76.09 Other incision of facial bone
Reopening of osteotomy site of facial bone
Excludes: osteotomy associated with orthognathic surgery (76.61-76.69)
removal of internal fixation device (76.97)
76.1 Diagnostic procedures on facial bones and joints
76.11 Biopsy of facial bone
76.19 Other diagnostic procedures on facial bones and joints
Excludes: contrast arthrogram of temporomandibular joint (87.13)
other x-ray (87.11-87.12, 87.14-87.16)
76.2 Local excision or destruction of lesion of facial bone
Excludes: biopsy of facial bone (76.11)
excision of odontogenic lesion (24.4)
76.3 Partial ostectomy of facial bone
76.31 Partial mandibulectomy
Hemimandibulectomy
Excludes: that associated with temporomandibular arthroplasty (76.5)
76.39 Partial ostectomy of other facial bone
Hemimaxillectomy (with bone graft or prosthesis)
76.4 Excision and reconstruction of facial bones
76.41 Total mandibulectomy with synchronous reconstruction
76.42 Other total mandibulectomy
76.43 Other reconstruction of mandible
Excludes: genioplasty (76.67-76.68)
that with synchronous total mandibulectomy (76.41)
76.44 Total ostectomy of other facial bone with synchronous reconstruction
76.45 Other total ostectomy of other facial bone
76.46 Other reconstruction of other facial bone
Excludes: that with synchronous total ostectomy (76.44)
76.5 Temporomandibular arthroplasty
76.6 Other facial bone repair and orthognathic surgery
Code also any synchronous:
bone graft (76.91)
synthetic implant (76.92)
Excludes: reconstruction of facial bones (76.41-76.46)
76.61 Closed osteoplasty [osteotomy] of mandibular ramus
Gigli saw osteotomy
76.62 Open osteoplasty [osteotomy] of mandibular ramus
76.63 Osteoplasty [osteotomy] of body of mandible
76.64 Other orthognathic surgery on mandible
Mandibular osteoplasty NOS
Segmental or subapical osteotomy
76.65 Segmental osteoplasty [osteotomy] of maxilla
Maxillary osteoplasty NOS
76.66 Total osteoplasty [osteotomy] of maxilla
76.67 Reduction genioplasty
Reduction mentoplasty
76.68 Augmentation genioplasty
Mentoplasty:
NOS
with graft or implant
76.69 Other facial bone repair
Osteoplasty of facial bone NOS
76.7 Reduction of facial fracture
Includes: internal fixation
Code also any synchronous:
bone graft (76.91)
synthetic implant (76.92)
Excludes: that of nasal bones (21.71-21.72)
76.70 Reduction of facial fracture, not otherwise specified
76.71 Closed reduction of malar and zygomatic fracture
76.72 Open reduction of malar and zygomatic fracture
76.73 Closed reduction of maxillary fracture
76.74 Open reduction of maxillary fracture
76.75 Closed reduction of mandibular fracture
76.76 Open reduction of mandibular fracture
76.77 Open reduction of alveolar fracture
Reduction of alveolar fracture with stabilization of teeth
76.78 Other closed reduction of facial fracture
Closed reduction of orbital fracture
Excludes: nasal bone (21.71)
76.79 Other open reduction of facial fracture
Open reduction of orbit rim or wall
Excludes: nasal bone (21.72)
76.9 Other operations on facial bones and joints
76.91 Bone graft to facial bone
Autogenous graft to facial bone
Bone bank graft to facial bone
Heterogenous graft to facial bone
76.92 Insertion of synthetic implant in facial bone
Alloplastic implant to facial bone
76.93 Closed reduction of temporomandibular dislocation
76.94 Open reduction of temporomandibular dislocation
76.95 Other manipulation of temporomandibular joint
76.96 Injection of therapeutic substance into temporomandibular joint
76.97 Removal of internal fixation device from facial bone
Excludes: removal of:
dental wiring (97.33)
external mandibular fixation device NEC (97.36)
76.99 Other
77 Incision, excision, and division of other bones
Excludes: laminectomy for decompression (03.09)
operations on:
accessory sinuses (22.00-22.9)
ear ossicles (19.0-19.55)
facial bones (76.01-76.99)
joint structures (80.00-81.99)
mastoid (19.9-20.99)
nasal bones (21.00-21.99)
skull (01.01-02.99)
The following fourth-digit subclassification is for use with appropriate categories in section 77 to identify the site. Valid fourth-digit categories are in brackets under each code.
0 unspecified site
1 scapula, clavicle, and thorax [ribs and sternum]
2 humerus
3 radius and ulna
4 carpals and metacarpals
5 femur
6 patella
7 tibia and fibula
8 tarsals and metatarsals
9 other
Pelvic bones
Phalanges (of foot) (of hand)
Vertebrae
77.0 Sequestrectomy
[0-9]
77.1 Other incision of bone without division
[0-9]
Reopening of osteotomy site
Excludes: aspiration of bone marrow (41.31, 41.91)
removal of internal fixation device (78.60-78.69)
77.2 Wedge osteotomy
[0-9]
Excludes: that for hallux valgus (77.51)
77.3 Other division of bone
[0-9]
Osteoarthrotomy
Excludes: clavicotomy of fetus (73.8)
laminotomy or incision of vertebra (03.01-03.09)
pubiotomy to assist delivery (73.94)
sternotomy incidental to thoracic operation -- omit code
77.4 Biopsy of bone
[0-9]
77.5 Excision and repair of bunion and other toe deformities
77.51 Bunionectomy with soft tissue correction and osteotomy of the first metatarsal
77.52 Bunionectomy with soft tissue correction and arthrodesis
77.53 Other bunionectomy with soft tissue correction
77.54 Excision or correction of bunionette
That with osteotomy
77.56 Repair of hammer toe
Fusion of hammer toe
Phalangectomy (partial) of hammer toe
Filleting of hammer toe
77.57 Repair of claw toe
Fusion of claw toe
Phalangectomy (partial) of claw toe
Capsulotomy of claw toe
Tendon lengthening of claw toe
77.58 Other excision, fusion and repair of toes
Cockup toe repair
Overlapping toe repair
That with use of prosthetic materials
77.59 Other bunionectomy
Resection of hallux valgus joint with insertion of prosthesis
77.6 Local excision of lesion or tissue of bone
[0-9]
Excludes: biopsy of bone (77.40-77.49)
debridement of compound fracture (79.60-79.69)
77.7 Excision of bone for graft
[0-9]
77.8 Other partial ostectomy
[0-9]
Condylectomy
Excludes: amputation (84.00-84.19, 84.91)
arthrectomy (80.90-80.99)
excision of bone ends associated with:
arthrodesis (81.00-81.39, 81.62-81.66)
arthroplasty (81.40-81.59, 81.71-81.85)
excision of cartilage (80.5-80.6, 80.80-80.99)
excision of head of femur with synchronous replacement (00.70-00.73, 81.51-81.53)
hemilaminectomy (03.01-03.09)
laminectomy (03.01-03.09)
ostectomy for hallux valgus (77.51-77.59)
partial amputation:
finger (84.01)
thumb (84.02)
toe (84.11)
resection of ribs incidental to thoracic operation -- omit code
that incidental to other operation -- omit code
77.9 Total ostectomy
[0-9]
Excludes: amputation of limb (84.00-84.19, 84.91)
that incidental to other operation -- omit code
78 Other operations on bones, except facial bones
Excludes: operations on:
accessory sinuses (22.00-22.9)
facial bones (76.01-76.99)
joint structures (80.00-81.99)
nasal bones (21.00-21.99)
skull (01.01-02.99)
The following fourth-digit subclassification is for use with categories in section 78 to identify the site. Valid fourth- digit categories are in [brackets] under each code.
0 unspecified site
1 scapula, clavicle, and thorax [ribs and sternum]
2 humerus
3 radius and ulna
4 carpals and metacarpals
5 femur
6 patella
7 tibia and fibula
8 tarsals and metatarsals
9 other
Pelvic bones
Phalanges (of foot) (of hand)
Vertebrae
78.0 Bone graft
[0-9]
Bone:
bank graft
graft (autogenous) (heterogenous)
That with debridement of bone graft site (removal of sclerosed, fibrous or necrotic bone or tissue)
Transplantation of bone
Code also any excision of bone for graft (77.70-77.79)
Excludes: that for bone lengthening (78.30-78.39)
78.1 Application of external fixator device
[0-9]
Fixator with insertion of pins/wires/screws into bone
Code also any type of fixator device, if known (84.71-84.73)
Excludes: other immobilization, pressure, and attention to wound (93.51-93.59)
78.2 Limb shortening procedures
[0,2-5,7-9]
Epiphyseal stapling
Open epiphysiodesis
Percutaneous epiphysiodesis
Resection/osteotomy
78.3 Limb lengthening procedures
[0,2-5,7-9]
Bone graft with or without internal fixation devices or osteotomy
Distraction technique with or without corticotomy/osteotomy
Code also any application of an external fixation device (78.10-78.19)
78.4 Other repair or plastic operations on bone
[0-9]
Other operation on bone NEC
Repair of malunion or nonunion fracture NEC
Excludes: application of external fixation device (78.10-78.19)
limb lengthening procedures (78.30-78.39)
limb shortening procedures (78.20-78.29)
osteotomy (77.3)
reconstruction of thumb (82.61-82.69)
repair of pectus deformity (34.74)
repair with bone graft (78.00-78.09)
78.5 Internal fixation of bone without fracture reduction
[0-9]
Internal fixation of bone (prophylactic)
Reinsertion of internal fixation device
Revision of displaced or broken fixation device
Excludes: arthroplasty and arthrodesis (81.00-81.85)
bone graft (78.00-78.09)
limb shortening procedures (78.20-78.29)
that for fracture reduction (79.10-79.19,79.30-79.59)
78.6 Removal of implanted devices from bone
[0-9]
External fixator device (invasive)
Internal fixation device
Removal of bone growth stimulator (invasive)
Removal of internal limb lengthening device
Removal of pedicle screw(s) used in spinal fusion
Excludes: removal of cast, splint, and traction device (Kirschner wire) (Steinmann pin) (97.88)
removal of posterior spinal motion preservation (facet replacement, pedicle-based dynamic stabilization, interspinous process) device(s) (80.09)
removal of skull tongs or halo traction device (02.95)
78.7 Osteoclasis
[0-9]
78.8 Diagnostic procedures on bone, not elsewhere classified
[0-9]
Excludes: biopsy of bone (77.40-77.49)
magnetic resonance imaging (88.94)
microscopic examination of specimen from bone (91.51-91.59)
radioisotope scan (92.14)
skeletal x-ray (87.21-87.29, 87.43, 88.21-88.33)
thermography (88.83)
78.9 Insertion of bone growth stimulator
[0-9]
Insertion of:
bone stimulator (electrical) to aid bone healing
osteogenic electrodes for bone growth stimulation
totally implanted device (invasive)
Excludes: non-invasive (transcutaneous) (surface) stimulator (99.86)
79 Reduction of fracture and dislocation
Includes: application of cast or splint reduction with insertion of traction device (Kirschner wire) (Steinmann pin)
Code also any:
application of external fixator device (78.10-78.19)
type of fixator device, if known (84.71-84.73)
Excludes: external fixation alone for immobilization of fracture (93.51-93.56, 93.59)
internal fixation without reduction of fracture (78.50-78.59)
operations on:
facial bones (76.70-76.79)
nasal bones (21.71-21.72)
orbit (76.78-76.79)
skull (02.02)
vertebrae (03.53)
removal of cast or splint (97.88)
replacement of cast or splint (97.11-97.14)
traction alone for reduction of fracture (93.41-93.46)
The following fourth-digit subclassification is for use with appropriate categories in section 79 to identify the site. Valid fourth-digit categories are in [brackets] under each code.
0 unspecified site
1 humerus
2 radius and ulna
Arm NOS
3 carpals and metacarpals
Hand NOS
4 phalanges of hand
5 femur
6 tibia and fibula
Leg NOS
7 tarsals and metatarsals
Foot NOS
8 phalanges of foot
9 other specified bone
79.0 Closed reduction of fracture without internal fixation
[0-9]
Excludes: that for separation of epiphysis (79.40-79.49)
79.1 Closed reduction of fracture with internal fixation
[0-9]
Excludes: that for separation of epiphysis (79.40-79.49)
79.2 Open reduction of fracture without internal fixation
[0-9]
Excludes: that for separation of epiphysis (79.50-79.59)
79.3 Open reduction of fracture with internal fixation
[0-9]
Excludes: that for separation of epiphysis (79.50-79.59)
79.4 Closed reduction of separated epiphysis
[0-2,5,6,9]
Reduction with or without internal fixation
79.5 Open reduction of separated epiphysis
[0-2,5,6,9]
Reduction with or without internal fixation
79.6 Debridement of open fracture site
[0-9]
Debridement of compound fracture
79.7 Closed reduction of dislocation
Includes: closed reduction (with external traction device)
Excludes: closed reduction of dislocation of temporomandibular joint (76.93)
79.70 Closed reduction of dislocation of unspecified site
79.71 Closed reduction of dislocation of shoulder
79.72 Closed reduction of dislocation of elbow
79.73 Closed reduction of dislocation of wrist
79.74 Closed reduction of dislocation of hand and finger
79.75 Closed reduction of dislocation of hip
79.76 Closed reduction of dislocation of knee
79.77 Closed reduction of dislocation of ankle
79.78 Closed reduction of dislocation of foot and toe
79.79 Closed reduction of dislocation of other specified sites
79.8 Open reduction of dislocation
Includes: open reduction (with internal and external fixation devices)
Excludes: open reduction of dislocation of temporomandibular joint (76.94)
79.80 Open reduction of dislocation of unspecified site
79.81 Open reduction of dislocation of shoulder
79.82 Open reduction of dislocation of elbow
79.83 Open reduction of dislocation of wrist
79.84 Open reduction of dislocation of hand and finger
79.85 Open reduction of dislocation of hip
79.86 Open reduction of dislocation of knee
79.87 Open reduction of dislocation of ankle
79.88 Open reduction of dislocation of foot and toe
79.89 Open reduction of dislocation of other specified sites
79.9 Unspecified operation on bone injury
[0-9]
80 Incision and excision of joint structures
Includes: operations on:
capsule of joint
cartilage
condyle
ligament
meniscus
synovial membrane
Excludes: cartilage of:
ear (18.01-18.9)
nose (21.00-21.99)
temporomandibular joint (76.01-76.99)
The following fourth-digit subclassification is for use with appropriate categories in section 80 to identify the site:
0 unspecified site
1 shoulder
2 elbow
3 wrist
4 hand and finger
5 hip
6 knee
7 ankle
8 foot and toe
9 other specified sites
Spine
80.0 Arthrotomy for removal of prosthesis without replacement
[0-9]
Includes removal of posterior spinal motion preservation (dynamic stabilization, facet replacement, interspinous process) device(s)
Code also any:
insertion of (cement)(joint) (methylmethacrylate) spacer (84.56)
removal of (cement)(joint) (methylmethacrylate) spacer (84.57)
Excludes: removal of pedicle screws used in spinal fusion (78.69)
80.1 Other arthrotomy
[0-9]
Arthrostomy
Excludes: that for:
arthrography (88.32)
arthroscopy (80.20-80.29)
injection of drug (81.92)
operative approach -- omit code
80.2 Arthroscopy
[0-9]
80.3 Biopsy of joint structure
[0-9]
Aspiration biopsy
80.4 Division of joint capsule, ligament, or cartilage
[0-9]
Goldner clubfoot release
Heyman-Herndon(-Strong) correction of metatarsus varus
Release of:
adherent or constrictive joint capsule
joint
ligament
Excludes: symphysiotomy to assist delivery (73.94)
that for:
carpal tunnel syndrome (04.43)
tarsal tunnel syndrome (04.44)
80.5 Excision, destruction and other repair of intervertebral disc
80.50 Excision or destruction of intervertebral disc, unspecified
Unspecified as to excision or destruction
80.51 Excision of intervertebral disc
Diskectomy
Removal of herniated nucleus pulposus
Level:
cervical
thoracic
lumbar (lumbosacral)
That by laminotomy or hemilaminectomy
That with decompression of spinal nerve root at same level
Requires additional code for any concomitant decompression of spinal nerve root at different level from excision site
Code also any: concurrent spinal fusion (81.00 - 81.09)
repair of the anulus fibrousus (80.53-80.54)
Excludes: that for insertion of (non-fusion) spinal disc replacement device (84.60 - 84.69)
that with corpectomy, (vertebral) (80.99)
intervertebral chemonucleolysis (80.52)
laminectomy for exploration of intraspinal canal (03.09)
laminotomy for decompression of spinal nerve root only (03.09)
80.52 Intervertebral chemonucleolysis
With aspiration of disc fragments
With diskography
Injection of proteolytic enzyme into intervertebral space (chymopapain)
Excludes: injection of anestheti substance (03.91)
injection of other substances (03.92)
80.53 Repair of the anulus fibrosus with graft or prosthesis
Anular disc repair
Closure (sealing) of the anulus fibrosus defect
Includes: microsurgical suture repair with fascial autograft
soft tissue re-approximation repair with tension bands
surgical mesh repair
Code also any:
application or administration of adhesion barrier substance, if performed (99.77)
intervertebral discectomy, if performed (80.51)
locally harvested fascia for graft (83.43)
80.54 Other and unspecified repair of the anulus fibrosus
Anular disc repair
Closure (sealing) of the anulus fibrosus defect
Microsurgical suture repair without fascial autograft
Percutaneous repair of the anulus fibrosus
Code also any:
application or administration of adhesion barrier substance, if performed (99.77)
intervertebral discectomy, if performed (80.51)
80.59 Other destruction of intervertebral disc
Destruction NEC
That by laser
80.6 Excision of semilunar cartilage of knee
Excision of meniscus of knee
80.7 Synovectomy
[0-9]
Complete or partial resection of synovial membrane
Excludes: excision of Baker's cyst (83.39)
80.8 Other local excision or destruction of lesion of joint
[0-9]
80.9 Other excision of joint
[0-9]
Excludes: cheilectomy of joint (77.80-77.89)
excision of bone ends (77.80-77.89)
81 Repair and plastic operations on joint structures
81.0 Spinal fusion
Includes: arthrodesis of spine with:
bone graft
internal fixation
Code also any insertion of interbody spinal fusion device (84.51)
any insertion of recombinant bone morphogenetic protein (84.52)
any synchronous excision of (locally) harvested bone for graft (77.70-77.79)
the total number of vertebrae fused (81.62-81.64)
Excludes:correction of pseudarthrosis of spine (81.30- 81.39)
refusion of spine (81.30 - 81.39)
81.00 Spinal fusion, not otherwise specified
81.01 Atlas-axis spinal fusion
Craniocervical fusion by anterior, transoral, or posterior technique
C1-C2 fusion by anterior, transoral, or posterior technique
Occiput C2 fusion by anterior, transoral, or posterior technique
81.02 Other cervical fusion, anterior technique
Arthrodesis of C2 level or below:
anterior (interbody) technique
anterolateral technique
81.03 Other cervical fusion, posterior technique
Arthrodesis of C2 level or below:
posterior (interbody) technique
posterolateral technique
81.04 Dorsal and dorsolumbar fusion, anterior technique
Arthrodesis of thoracic or thoracolumbar region:
anterior (interbody) technique
anterolateral technique
81.05 Dorsal and dorsolumbar fusion, posterior technique
Arthrodesis of thoracic or thoracolumbar region:
posterior (interbody) technique
posterolateral technique
81.06 Lumbar and lumbosacral fusion, anterior technique
Anterior lumbar interbody fusion (ALIF)
Arthrodesis of lumbar or lumbosacral region:
anterior (interbody) technique
anterolateral technique
81.07 Lumbar and lumbosacral fusion, lateral transverse process technique
81.08 Lumbar and lumbosacral fusion, posterior technique
Arthrodesis of lumbar or lumbosacral region:
posterior (interbody) technique
posterolateral technique
Posterior lumbar interbody fusion (PLIF)
Transforaminal lumbar interbody fusion (TLIF)
81.1 Arthrodesis and arthroereisis of foot and ankle
Includes: arthrodesis of foot and ankle with:
bone graft
external fixation device
81.11 Ankle fusion
Tibiotalar fusion
81.12 Triple arthrodesis
Talus to calcaneus and calcaneus to cuboid and navicular
81.13 Subtalar fusion
Excludes: arthroereisis (81.18)
81.14 Midtarsal fusion
81.15 Tarsometatarsal fusion
81.16 Metatarsophalangeal fusion
81.17 Other fusion of foot
81.18 Subtalar joint arthroereisis
81.2 Arthrodesis of other joint
Includes: arthrodesis with:
bone graft
external fixation device
excision of bone ends and compression
81.20 Arthrodesis of unspecified joint
81.21 Arthrodesis of hip
81.22 Arthrodesis of knee
81.23 Arthrodesis of shoulder
81.24 Arthrodesis of elbow
81.25 Carporadial fusion
81.26 Metacarpocarpal fusion
81.27 Metacarpophalangeal fusion
81.28 Interphalangeal fusion
81.29 Arthrodesis of other specified joints
81.3 Refusion of spine
Includes: arthrodesis of spine with:
bone graft
internal fixation
correction of pseudarthrosis of spine
Code also any insertion of interbody spinal fusion device (84.51)
any insertion of recombinant bone morphogenetic protein (84.52)
any synchronous excision of (locally) harvested bone for graft (77.70-77.79)
the total number of vertebrae fused (81.62-81.64)
81.30 Refusion of spine, not otherwise specified
81.31 Refusion of atlas-axis spine
Craniocervical fusion by anterior, transoral, or posterior technique
C1-C2 fusion by anterior, transoral, or posterior technique
Occiput C2 fusion by anterior, transoral, or posterior technique
81.32 Refusion of other cervical spine, anterior technique
Arthrodesis of C2 level or below:
anterior (interbody) technique
anterolateral technique
81.33 Refusion of other cervical spine, posterior technique
Arthrodesis of C2 level or below:
posterior (interbody) technique
posterolateral technique
81.34 Refusion of dorsal and dorsolumbar spine, anterior technique
Arthrodesis of thoracic or thoracolumbar region:
anterior (interbody) technique
anterolateral technique
81.35 Refusion of dorsal and dorsolumbar spine, posterior technique
Arthrodesis of thoracic or thoracolumbar region:
posterior (interbody) technique
posterolateral technique
81.36 Refusion of lumbar and lumbosacral spine, anterior technique
Anterior lumbar interbody fusion (ALIF)
Arthrodesis of lumbar or lumbosacral region:
anterior (interbody) technique
anterolateral technique
81.37 Refusion of lumbar and lumbosacral spine, lateral transverse process technique
81.38 Refusion of lumbar and lumbosacral spine, posterior technique
Arthrodesis of lumbar or lumbosacral region:
posterior (interbody) technique
posterolateral technique
Posterior lumbar interbody fusion (PLIF)
Transforaminal lumbar interbody fusion (TLIF)
81.39 Refusion of spine, not elsewhere classified
81.4 Other repair of joint of lower extremity
Includes: arthroplasty of lower extremity with:
external traction or fixation
graft of bone (chips) or cartilage
internal fixation device
81.40 Repair of hip, not elsewhere classified
81.42 Five-in-one repair of knee
Medial meniscectomy, medial collateral ligament repair, vastus medialis advancement, semitendinosus advancement, and pes anserinus transfer
81.43 Triad knee repair
Medial meniscectomy with repair of the anterior cruciate ligament and the medial collateral ligament
O'Donoghue procedure
81.44 Patellar stabilization
Roux-Goldthwait operation for recurrent dislocation of patella
81.45 Other repair of the cruciate ligaments
81.46 Other repair of the collateral ligaments
81.47 Other repair of knee
81.49 Other repair of ankle
81.5 Joint replacement of lower extremity
Includes: arthroplasty of lower extremity with:
external traction or fixation
graft of bone (chips) or cartilage
internal fixation device or prosthesis
Note: removal of prior prosthesis - omit code
81.51 Total hip replacement
Replacement of both femoral head and acetabulum by prosthesis
Total reconstruction of hip
Code also any type of bearing surface, if known (00.74-0 0.77)
81.52 Partial hip replacement
Bipolar endoprosthesis
Code also any type of bearing surface, if known (00.74 - 00.77)
81.53 Revision of hip replacement, not otherwise specified
Revision of hip replacement, not specified as to components(s) replaced, (acetabular, femoral or both)
Code also any:
removal of (cement)(joint) spacer (84.57)
type of bearing surface, if known (00.74-00.77)
Excludes: revision of hip replacement, components specified (00.70-00.73)
81.54 Total knee replacement
Bicompartmental
Partial knee replacement
Tricompartmental
Unicompartmental (hemijoint)
81.55 Revision of knee replacement,not otherwise specified
Code also any removal of (cement) spacer (84.57)
Excludes: arthrodesis of knee (81.22)
revision of knee replacement, components specified (00.80-00.84)
81.56 Total ankle replacement
81.57 Replacement of joint of foot and toe
81.59 Revision of joint replacement of lower extremity, not elsewhere classified
81.6 Other procedures on spine
Note: Number of vertebrae
The vertebral spine consists of 25 vertebrae in the following order and number:
Cervical: C1 (atlas), C2 (axis), C3, C4, C5, C6, C7
Thoracic or Dorsal: T1, T2, T3, T4, T5, T6, T7, T8, T9, T10, T11, T12
Lumbar and Sacral: L1, L2, L3, L4, L5, S1
Coders should report only one code from the series 81.62 or 81.63 or 81.64 to show the total number of vertebrae fused on the patient.
Code also the level and approach of the fusion or refusion (81.00-81.08, 81.30-81.39)
81.62 Fusion or refusion of 2-3 vertebrae
81.63 Fusion or refusion of 4- 8 vertebrae
81.64 Fusion or refusion of 9 or more vertebrae
81.65 Percutaneous vertebroplasty
Injection of bone void filler (cement) (polymethylmethacrylate) (PMMA) into the diseased or fractured
vertebral body
Excludes: percutaneous vertebral augmentation (81.66)
81.66 Percutaneous vertebral augmentation
Insertion of inflatable balloon, bone tamp, or other device displacing (removing) (compacting) bone to create a space (cavity) (void) prior to the injection of bone void filler (cement) (polymethylmethacrylate) (PMMA) or other substance
Arcuplasty
Kyphoplasty
SKyphoplasty
Spineoplasty
Excludes: percutaneous vertebroplasty (81.65)
81.7 Arthroplasty and repair of hand, fingers and wrist
Includes: arthroplasty of hand and finger with:
external traction or fixation
graft of bone (chips) or cartilage
internal fixation device or prosthesis
Excludes: operations on muscle, tendon and fascia of hand (82.01-82.99)
81.71 Arthroplasty of metacarpophalangeal and interphalangeal joint with implant
81.72 Arthroplasty of metacarpophalangeal and interphalangeal joint without implant
81.73 Total wrist replacement
81.74 Arthroplasty of carpocarpal or carpometacarpal joint with implant
81.75 Arthroplasty of carpocarpal or carpometacarpal joint without implant
81.79 Other repair of hand, fingers and wrist
81.8 Arthroplasty and repair of shoulder and elbow
Includes: arthroplasty of upper limb NEC with:
external traction or fixation
graft of bone (chips) or cartilage
internal fixation device or prosthesis
81.80 Total shoulder replacement
81.81 Partial shoulder replacement
81.82 Repair of recurrent dislocation of shoulder
81.83 Other repair of shoulder
Revision of arthroplasty of shoulder
81.84 Total elbow replacement
Partial elbow replacement
81.85 Other repair of elbow
81.9 Other operations on joint structures
81.91 Arthrocentesis
Joint aspiration
Excludes: that for:
arthrography (88.32)
biopsy of joint structure 80.30-80.39)
injection of drug (81.92)
81.92 Injection of therapeutic substance into joint or ligament
81.93 Suture of capsule or ligament of upper extremity
Excludes: that associated wit arthroplasty (81.71-81.75, 81.80-81.81, 81.84)
81.94 Suture of capsule or ligament of ankle and foot
Excludes: that associated wit arthroplasty (81.56-81.59)
81.95 Suture of capsule or ligament of other lower extremity
Excludes: that associated wit arthroplasty (81.51-81.55, 81.59)
81.96 Other repair of joint
81.97 Revision of joint replacement of upper extremity
Partial
Removal of cement spacer
Total
81.98 Other diagnostic procedures on joint structures
Excludes: arthroscopy (80.20-80.29)
biopsy of joint structure (80.30-80.39)
microscopic examination of specimen from joint (91.51-91.59)
thermography (88.83)
x-ray (87.21-87.29, 88.21-88.33)
81.99 Other
82 Operations on muscle, tendon, and fascia of hand
Includes: operations on:
aponeurosis
synovial membrane (tendon sheath)
tendon sheath
82.0 Incision of muscle, tendon, fascia, and bursa of hand
82.01 Exploration of tendon sheath of hand
Incision of tendon sheath of hand
Removal of rice bodies in tendon sheath of hand
Excludes: division of tendon (82.11)
82.02 Myotomy of hand
Excludes: myotomy for division (82.19)
82.03 Bursotomy of hand
82.04 Incision and drainage of palmar or thenar space
82.09 Other incision of soft tissue of hand
Excludes: incision of skin an subcutaneous tissue alone (86.01-86.09)
82.1 Division of muscle, tendon, and fascia of hand
82.11 Tenotomy of hand
Division of tendon of hand
82.12 Fasciotomy of hand
Division of fascia of hand
82.19 Other division of soft tissue of hand
Division of muscle of hand
82.2 Excision of lesion of muscle, tendon, and fascia of hand
82.21 Excision of lesion of tendon sheath of hand
Ganglionectomy of tendon sheath (wrist)
82.22 Excision of lesion of muscle of hand
82.29 Excision of other lesion of soft tissue of hand
Excludes: excision of lesion of skin and subcutaneous tissue (86.21-86.3)
82.3 Other excision of soft tissue of hand
Code also any skin graft (86.61-86.62, 86.73)
Excludes: excision of skin and subcutaneous tissue (86.21-86.3)
82.31 Bursectomy of hand
82.32 Excision of tendon of hand for graft
82.33 Other tenonectomy of hand
Tenosynovectomy of hand
Excludes: excision of lesion of:
tendon (82.29)
sheath (82.21)
82.34 Excision of muscle or fascia of hand for graft
82.35 Other fasciectomy of hand
Release of Dupuytren's contracture
Excludes: excision of lesion of fascia (82.29)
82.36 Other myectomy of hand
Excludes: excision of lesion of muscle (82.22)
82.39 Other excision of soft tissue of hand
Excludes: excision of skin (86.21-86.3)
excision of soft tissue lesion (82.29)
82.4 Suture of muscle, tendon, and fascia of hand
82.41 Suture of tendon sheath of hand
82.42 Delayed suture of flexor tendon of hand
82.43 Delayed suture of other tendon of hand
82.44 Other suture of flexor tendon of hand
Excludes: delayed suture of flexor tendon of hand (82.42)
82.45 Other suture of other tendon of hand
Excludes: delayed suture of other tendon of hand (82.43)
82.46 Suture of muscle or fascia of hand
82.5 Transplantation of muscle and tendon of hand
82.51 Advancement of tendon of hand
82.52 Recession of tendon of hand
82.53 Reattachment of tendon of hand
82.54 Reattachment of muscle of hand
82.55 Other change in hand muscle or tendon length
82.56 Other hand tendon transfer or transplantation
Excludes: pollicization of thumb (82.61)
transfer of finger, except thum (82.81)
82.57 Other hand tendon transposition
82.58 Other hand muscle transfer or transplantation
82.59 Other hand muscle transposition
82.6 Reconstruction of thumb
Includes: digital transfer to act as thumb
Code also any amputation for digital transfer (84.01, 84.11)
82.61 Pollicization operation carrying over nerves and blood supply
82.69 Other reconstruction of thumb
"Cocked-hat" procedure [skin flap and bone]
Grafts:
bone to thumb skin (pedicle) to thumb
82.7 Plastic operation on hand with graft or implant
82.71 Tendon pulley reconstruction
Reconstruction for opponensplasty
82.72 Plastic operation on hand with graft of muscle or fascia
82.79 Plastic operation on hand with other graft or implant
Tendon graft to hand
82.8 Other plastic operations on hand
82.81 Transfer of finger, except thumb
Excludes: pollicization of thumb (82.61)
82.82 Repair of cleft hand
82.83 Repair of macrodactyly
82.84 Repair of mallet finger
82.85 Other tenodesis of hand
Tendon fixation of hand NOS
82.86 Other tenoplasty of hand
Myotenoplasty of hand
82.89 Other plastic operations on hand
Plication of fascia
Repair of fascial hernia
Excludes: that with graft or implant (82.71-82.79)
82.9 Other operations on muscle, tendon, and fascia of hand
Excludes: diagnostic procedures on soft tissue of hand (83.21-83.29)
82.91 Lysis of adhesions of hand
Freeing of adhesions of fascia, muscle, and tendon of hand
Excludes: decompression of carpal tunnel (04.43)
that by stretching o manipulation only (93.26)
82.92 Aspiration of bursa of hand
82.93 Aspiration of other soft tissue of hand
Excludes: skin and subcutaneous tissue (86.01)
82.94 Injection of therapeutic substance into bursa of hand
82.95 Injection of therapeutic substance into tendon of hand
82.96 Other injection of locally-acting therapeutic substance into soft tissue of hand
Excludes: subcutaneous or intramuscular injection (99.11-99.29)
82.99 Other operations on muscle, tendon, and fascia of hand
83 Operations on muscle, tendon, fascia, and bursa, except hand
Includes: operations on:
aponeurosis
synovial membrane of bursa and tendon sheaths
tendon sheaths
Excludes: diaphragm (34.81-34.89)
hand (82.01-82.99)
muscles of eye (15.01-15.9)
83.0 Incision of muscle, tendon, fascia, and bursa
83.01 Exploration of tendon sheath
Incision of tendon sheath
Removal of rice bodies from tendon sheath
83.02 Myotomy
Excludes: cricopharyngeal myotomy (29.31)
83.03 Bursotomy
Removal of calcareous deposit of bursa
Excludes: aspiration of burs (percutaneous) (83.94)
83.09 Other incision of soft tissue
Incision of fascia
Excludes: incision of skin an subcutaneous tissue alone (86.01-86.09)
83.1 Division of muscle, tendon, and fascia
83.11 Achillotenotomy
83.12 Adductor tenotomy of hip
83.13 Other tenotomy
Aponeurotomy
Division of tendon
Tendon release
Tendon transection
Tenotomy for thoracic outlet decompression
83.14 Fasciotomy
Division of fascia
Division of iliotibial band
Fascia stripping
Release of Volkmann's contracture by fasciotomy
83.19 Other division of soft tissue
Division of muscle
Muscle release
Myotomy for thoracic outlet decompression
Myotomy with division
Scalenotomy
Transection of muscle
83.2 Diagnostic procedures on muscle, tendon, fascia, and bursa, including that of hand
83.21 Biopsy of soft tissue
Excludes: biopsy of chest wall (34.23)
biopsy of skin and subcutaneous tissue (86.11)
83.29 Other diagnostic procedures on muscle, tendon, fascia, and bursa, including that of hand
Excludes: microscopic examination of specimen (91.51-91.59)
soft tissue x-ray (87.09, 87.38-87.39, 88.09, 88.35, 88.37)
thermography of muscle (88.84)
83.3 Excision of lesion of muscle, tendon, fascia, and bursa
Excludes: biopsy of soft tissue (83.21)
83.31 Excision of lesion of tendon sheath
Excision of ganglion of tendon sheath, except of hand
83.32 Excision of lesion of muscle
Excision of:
heterotopic bone
muscle scar for release of Volkmann's contracture
myositis ossificans
83.39 Excision of lesion of other soft tissue
Excision of Baker's cyst
Excludes: bursectomy (83.5)
excision of lesion of skin and subcutaneous tissue (86.3)
synovectomy (80.70-80.79)
83.4 Other excision of muscle, tendon, and fascia
83.41 Excision of tendon for graft
83.42 Other tenonectomy
Excision of:
aponeurosis
tendon sheath
Tenosynovectomy
83.43 Excision of muscle or fascia for graft
83.44 Other fasciectomy
83.45 Other myectomy
Debridement of muscle NOS
Scalenectomy
83.49 Other excision of soft tissue
83.5 Bursectomy
83.6 Suture of muscle, tendon, and fascia
83.61 Suture of tendon sheath
83.62 Delayed suture of tendon
83.63 Rotator cuff repair
83.64 Other suture of tendon
Achillorrhaphy
Aponeurorrhaphy
Excludes: delayed suture of tendon (83.62)
83.65 Other suture of muscle or fascia
Repair of diastasis recti
83.7 Reconstruction of muscle and tendon
Excludes: reconstruction of muscle and tendon associated with arthroplasty
83.71 Advancement of tendon
83.72 Recession of tendon
83.73 Reattachment of tendon
83.74 Reattachment of muscle
83.75 Tendon transfer or transplantation
83.76 Other tendon transposition
83.77 Muscle transfer or transplantation
Release of Volkmann's contracture by muscle transplantation
83.79 Other muscle transposition
83.8 Other plastic operations on muscle, tendon, and fascia
Excludes: plastic operations on muscle, tendon, and fascia associated with arthroplasty
83.81 Tendon graft
83.82 Graft of muscle or fascia
83.83 Tendon pulley reconstruction
83.84 Release of clubfoot, not elsewhere classified
Evans operation on clubfoot
83.85 Other change in muscle or tendon length
Hamstring lengthening
Heel cord shortening
Plastic achillotenotomy
Tendon plication
83.86 Quadricepsplasty
83.87 Other plastic operations on muscle
Musculoplasty
Myoplasty
83.88 Other plastic operations on tendon
Myotenoplasty
Tendon fixation
Tenodesis
Tenoplasty
83.89 Other plastic operations on fascia
Fascia lengthening
Fascioplasty
Plication of fascia
83.9 Other operations on muscle, tendon, fascia, and bursa
Excludes: nonoperative:
manipulation (93.25-93.29)
stretching (93.27-93.29)
83.91 Lysis of adhesions of muscle, tendon, fascia, and bursa
Excludes: that for tarsal tunnel syndrome (04.44)
83.92 Insertion or replacement of skeletal muscle stimulator
Implantation, insertion, placement, or replacement of skeletal muscle:
electrodes
stimulator
83.93 Removal of skeletal muscle stimulator
83.94 Aspiration of bursa
83.95 Aspiration of other soft tissue
Excludes: that of skin and subcutaneous tissue (86.01)
83.96 Injection of therapeutic substance into bursa
83.97 Injection of therapeutic substance into tendon
83.98 Injection of locally-acting therapeutic substance into other soft tissue
Excludes: subcutaneous or intramuscular injection (99.11-99.29)
83.99 Other operations on muscle, tendon, fascia, and bursa
Suture of bursa
84 Other procedures on musculoskeletal system
84.0 Amputation of upper limb
Excludes: revision of amputation stump (84.3)
84.00 Upper limb amputation, not otherwise specified
Closed flap amputation of upper limb NOS
Kineplastic amputation of upper limb NOS
Open or guillotine amputation of upper limb NOS
Revision of current traumatic amputation of upper limb NOS
84.01 Amputation and disarticulation of finger
Excludes: ligation of supernumerary finge (86.26)
84.02 Amputation and disarticulation of thumb
84.03 Amputation through hand
Amputation through carpals
84.04 Disarticulation of wrist
84.05 Amputation through forearm
Forearm amputation
84.06 Disarticulation of elbow
84.07 Amputation through humerus
Upper arm amputation
84.08 Disarticulation of shoulder
84.09 Interthoracoscapular amputation
Forequarter amputation
84.1 Amputation of lower limb
Excludes: revision of amputation stump (84.3)
84.10 Lower limb amputation, not otherwise specified
Closed flap amputation of lower limb NOS
Kineplastic amputation of lower limb NOS
Open or guillotine amputation of lower limb NOS
Revision of current traumatic amputation of lower limb NOS
84.11 Amputation of toe
Amputation through metatarsophalangeal joint
Disarticulation of toe
Metatarsal head amputation
Ray amputation of foot (disarticulation of the metatarsal head of the toe extending across the forefoot just proximal to the metatarsophalangeal crease)
Excludes: ligation of supernumerary toe (86.26)
84.12 Amputation through foot
Amputation of forefoot
Amputation through middle of foot
Chopart's amputation
Midtarsal amputation
Transmetatarsal amputation (amputation of the forefoot, including all the toes)
Excludes: Ray amputation of foot (84.11)
84.13 Disarticulation of ankle
84.14 Amputation of ankle through malleoli of tibia and fibula
84.15 Other amputation below knee
Amputation of leg through tibia and fibula NOS
84.16 Disarticulation of knee
Batch, Spitler, and McFaddin amputation
Mazet amputation
S.P. Roger's amputation
84.17 Amputation above knee
Amputation of leg through femur
Amputation of thigh
Conversion of below-knee amputation into above-knee amputation
Supracondylar above-knee amputation
84.18 Disarticulation of hip
84.19 Abdominopelvic amputation
Hemipelvectomy
Hindquarter amputation
84.2 Reattachment of extremity
84.21 Thumb reattachment
84.22 Finger reattachment
84.23 Forearm, wrist, or hand reattachment
84.24 Upper arm reattachment
Reattachment of arm NOS
84.25 Toe reattachment
84.26 Foot reattachment
84.27 Lower leg or ankle reattachment
Reattachment of leg NOS
84.28 Thigh reattachment
84.29 Other reattachment
84.3 Revision of amputation stump
Reamputation of stump
Secondary closure of stump
Trimming of stump
Excludes: revision of current traumatic amputation [revision by further amputation of current injury] (84.00-84.19, 84.91)
84.4 Implantation or fitting of prosthetic limb device
84.40 Implantation or fitting of prosthetic limb device, not otherwise specified
84.41 Fitting of prosthesis of upper arm and shoulder
84.42 Fitting of prosthesis of lower arm and hand
84.43 Fitting of prosthesis of arm, not otherwise specified
84.44 Implantation of prosthetic device of arm
84.45 Fitting of prosthesis above knee
84.46 Fitting of prosthesis below knee
84.47 Fitting of prosthesis of leg, not otherwise specified
84.48 Implantation of prosthetic device of leg
84.5 Implantation of other musculoskeletal devices and substances
Excludes: insertion of (non-fusion) spinal disc replacement device (84.60 - 84.69)
84.51 Insertion of interbody spinal fusion device
Insertion of:cages (carbon, ceramic, metal, plastic or titanium)
interbody fusion cage
synthetic cages or spacers
threaded bone dowels
Code also refusion of spine (81.30 - 81.39)
Code also spinal fusion (81.00 - 81.08)
84.52 Insertion of recombinant bone morphogenetic protein
rhBMP
That via collagen sponge, coral, ceramic and other carriers
Code also primary procedure performed:
fracture repair (79.00-79.99)
spinal fusion (81.00 - 81.08)
spinal refusion (81.30 - 81.39)
84.53 Implantation of internal limb lengthening device with kinetic distraction
Code also limb lengthening procedure (78.30 - 78.39)
84.54 Implantation of other internal limb lengthening device
Implantation of internal limb lengthening device, Not Otherwise Specified (NOS)
Code also limb lengthening procedure (78.30 - 78.39)
84.55 Insertion of bone void filler
Insertion of:
acrylic cement (PMMA)
bone void cement
calcium based bone void filler
polymethylmethacrylate (PMMA)
Excludes: that with percutaneous vertebral augmentation (81.66)
that with percutaneous vertebroplasty (81.65)
84.56 Insertion or replacement of (cement) spacer
Insertion or replacement of joint (methylmethacrylate) spacer
84.57 Removal of (cement) spacer
Removal of joint (methylmethacrylate) spacer
84.59 Insertion of other spinal devices
Excludes: initial insertion of pedicle screws with spinal fusion-omit code
insertion of facet replacement device(s) (84.84)
insertion of interspinous process device(s) (84.80)
insertion of pedicle-based dynamic stabilization device(s) (84.82)
84.6 Replacement of spinal disc
Includes: non-fusion arthroplasty of the spine with insertion of artificial disc prosthesis
84.60 Insertion of spinal disc prosthesis, not otherwise specified
Replacement of spinal disc, NOS
Includes: diskectomy (discectomy)
84.61 Insertion of partial spinal disc prosthesis, cervical
Nuclear replacement device, cervical
Partial artificial disc prosthesis (flexible), cervical
Replacement of nuclear disc (nucleus pulposus), cervical
Includes: diskectomy (discectomy)
84.62 Insertion of total spinal disc prosthesis, cervical
Replacement of cervical spinal disc, NOS
Replacement of total spinal disc, cervical
Total artificial disc prosthesis (flexible), cervical
Includes: diskectomy (discectomy)
84.63 Insertion of spinal disc prosthesis, thoracic
Artificial disc prosthesis (flexible), thoracic
Replacement of thoracic spinal disc, partial or total
Includes: diskectomy (discectomy)
84.64 Insertion of partial spinal disc prosthesis, lumbosacral
Nuclear replacement device, lumbar
Partial artificial disc prosthesis (flexible), lumbar
Replacement of nuclear disc (nucleus pulposus), lumbar
Includes: diskectomy (discectomy)
84.65 Insertion of total spinal disc prosthesis, lumbosacral
Replacement of lumbar spinal disc, NOS
Replacement of total spinal disc, lumbar
Total artificial disc prosthesis (flexible), lumbar
Includes: diskectomy (discectomy)
84.66 Revision or replacement of artificial spinal disc prosthesis, cervical
Removal of (partial) (total) spinal disc prosthesis with synchronous insertion of new (partial) (total) spinal
disc prosthesis, cervical
Repair of previously inserted spinal disc prosthesis, cervical
84.67 Revision or replacement of artificial spinal disc prosthesis, thoracic
Removal of (partial) (total) spinal disc prosthesis with synchronous insertion of new (partial) (total) spinal
disc prosthesis, thoracic
Repair of previously inserted spinal disc prosthesis, thoracic
84.68 Revision or replacement of artificial spinal disc prosthesis, lumbosacral
Removal of (partial) (total) spinal disc prosthesis with synchronous insertion of new (partial)(total) spinal
disc prosthesis, lumbosacral
Repair of previously inserted spinal disc prosthesis, lumbosacral
84.69 Revision or replacement of artificial spinal disc prosthesis, not otherwise specified
Removal of (partial) (total) spinal disc prosthesis with synchronous insertion of new (partial)(total) spinal
disc prosthesis
Repair of previously inserted spinal disc prosthesis
84.7 Adjunct codes for external fixator devices
Code also any primary procedure performed:
application of external fixator device (78.10, 78.12-78.13, 78.15, 78.17- 78.19)
reduction of fracture and dislocation (79.00-79.89)
84.71 Application of external fixator device, monoplanar system
Excludes: other hybrid device or system (84.73)
ring device or system (84.72)
84.72 Application of external fixator device, ring system
Ilizarov type
Sheffield type
Excludes: monoplanar device or system (84.71)
other hybrid device or system (84.73)
84.73 Application of hybrid external fixator device
Computer (assisted) (dependent) external fixator device
Hybrid system using both ring and monoplanar devices
Excludes: monoplanar device or system, when used alone (84.71)
ring device or system, when used alone (84.72)
84.8 Insertion, replacement and revision of posterior spinal motion preservation device(s)
Dynamic spinal stabilization device(s)
Includes any synchronous facetectomy (partial, total) performed at the same level
Code also any synchronous surgical decompression (foraminotomy, laminectomy, laminotomy), if performed (03.09)
Excludes: fusion of spine (81.00 - 81.08, 81.30-81.39)
insertion of artificial disc prosthesis (84.60-84.69)
insertion of interbody spinal fusion device (84.51)
84.80 Insertion or replacement of interspinous process device(s)
Interspinous process decompression device(s)
Interspinous process distraction device(s)
Excludes: insertion or replacement of facet replacement device (84.84)
insertion or replacement of pedicle-based dynamic stabilization device (84.82)
84.81 Revision of interspinous process device(s)
Repair of previously inserted interspinous process device(s)
Excludes: revision of facet replacement device(s) (84.85)
revision of pedicle-based dynamic stabilization device (84.83)
84.82 Insertion or replacement of pedicle-based dynamic stabilization device(s)
Excludes: initial insertion of pedicle screws with spinal fusion - omit code
insertion or replacement of facet replacement device(s) (84.84)
insertion or replacement of interspinous process device(s) (84.80)
replacement of pedicle screws used in spinal fusion (78.59)
84.83 Revision of pedicle-based dynamic stabilization device(s)
Repair of previously inserted pedicle-based dynamic stabilization device(s)
Excludes: removal of pedicle screws used in spinal fusion (78.69)
replacement of pedicle screws used in spinal fusion (78.59)
revision of facet replacement device(s) (84.85)
revision of interspinous process device(s) (84.81)
84.84 Insertion or replacement of facet replacement device(s)
Facet arthroplasty
Excludes: initial insertion of pedicle screws with spinal fusion- omit code
insertion or replacement of interspinous process device(s) (84.80)
insertion or replacement of pedicle-based dynamic stabilization device(s) (84.82)
replacement of pedicle screws used in spinal fusion (78.59)
84.85 Revision of facet replacement device(s)
Repair of previously inserted facet replacement device(s)
Excludes: removal of pedicle screws used in spinal fusion (78.69)
replacement of pedicle screws used in spinal fusion (78.59)
revision of interspinous process device(s) (84.81)
revision of pedicle-based dynamic stabilization device(s) (84.83)
84.9 Other operations on musculoskeletal system
Excludes: nonoperative manipulation (93.25-93.29)
84.91 Amputation, not otherwise specified
84.92 Separation of equal conjoined twins
84.93 Separation of unequal conjoined twins
Separation of conjoined twins NOS
84.99 Other
15. OPERATIONS ON THE INTEGUMENTARY SYSTEM (85-86)
85 Operations on the breast
Includes: operations on the skin and subcutaneous tissue of:
breast female or male
previous mastectomy site female or male
revision of previous mastectomy site
85.0 Mastotomy
Incision of breast (skin)
Mammotomy
Excludes: aspiration of breast (85.91)
removal of implant (85.94)
85.1 Diagnostic procedures on breast
85.11 Closed [percutaneous] [needle] biopsy of breast
85.12 Open biopsy of breast
85.19 Other diagnostic procedures on breast
Excludes: mammary ductogram (87.35)
mammography NEC (87.37)
manual examination (89.36)
microscopic examination of specimen (91.61-91.69)
thermography (88.85)
ultrasonography (88.73)
xerography (87.36)
85.2 Excision or destruction of breast tissue
Excludes: mastectomy (85.41-85.48)
reduction mammoplasty (85.31-85.32)
85.20 Excision or destruction of breast tissue, not otherwise specified
Excludes: laser interstitial thermal therapy [LITT] of lesion or tissue of breast under guidance (17.69)
85.21 Local excision of lesion of breast
Lumpectomy
Removal of area of fibrosis from breast
Excludes: biopsy of breast (85.11-85.12)
85.22 Resection of quadrant of breast
85.23 Subtotal mastectomy
Excludes: quadrant resection (85.22)
85.24 Excision of ectopic breast tissue
Excision of accessory nipple
85.25 Excision of nipple
Excludes: excision of accessory nipple (85.24)
85.3 Reduction mammoplasty and subcutaneous mammectomy
85.31 Unilateral reduction mammoplasty
Unilateral:
amputative mammoplasty
size reduction mammoplasty
85.32 Bilateral reduction mammoplasty
Amputative mammoplasty
Reduction mammoplasty (for gynecomastia)
85.33 Unilateral subcutaneous mammectomy with synchronous implant
Excludes: that without synchronous implan (85.34)
85.34 Other unilateral subcutaneous mammectomy
Removal of breast tissue with preservation of skin and nipple
Subcutaneous mammectomy NOS
85.35 Bilateral subcutaneous mammectomy with synchronous implant
Excludes: that without synchronous implan (85.36)
85.36 Other bilateral subcutaneous mammectomy
85.4 Mastectomy
85.41 Unilateral simple mastectomy
Mastectomy:
NOS
complete
85.42 Bilateral simple mastectomy
Bilateral complete mastectomy
85.43 Unilateral extended simple mastectomy
Extended simple mastectomy NOS
Modified radical mastectomy
Simple mastectomy with excision of regional lymph nodes
85.44 Bilateral extended simple mastectomy
85.45 Unilateral radical mastectomy
Excision of breast, pectoral muscles, and regional lymph nodes [axillary, clavicular, supraclavicular]
Radical mastectomy NOS
85.46 Bilateral radical mastectomy
85.47 Unilateral extended radical mastectomy
Excision of breast, muscles, and lymph nodes [axillary, clavicular, supraclavicular, internal mammary, and mediastinal]
Extended radical mastectomy NOS
85.48 Bilateral extended radical mastectomy
85.5 Augmentation mammoplasty
Excludes: that associated with subcutaneous mammectomy (85.33, 85.35)
85.50 Augmentation mammoplasty, not otherwise specified
85.51 Unilateral injection into breast for augmentation
85.52 Bilateral injection into breast for augmentation
Injection into breast for augmentation NOS
85.53 Unilateral breast implant
85.54 Bilateral breast implant
Breast implant NOS
85.6 Mastopexy
85.7 Total reconstruction of breast
85.70 Total reconstruction of breast, not otherwise specified
Perforator flap, free
85.71 Latissimus dorsi myocutaneous flap
85.72 Transverse rectus abdominis myocutaneous (TRAM) flap, pedicled
Excludes: transverse rectus abdominis myocutaneous (TRAM) flap, free (85.73)
85.73 Transverse rectus abdominis myocutaneous (TRAM) flap, free
Excludes: transverse rectus abdominis myocutaneous (TRAM) flap, pedicled (85.72)
85.74 Deep inferior epigastric artery perforator (DIEP) flap, free
85.75 Superficial inferior epigastric artery (SIEA) flap, free
85.76 Gluteal artery perforator (GAP) flap, free
85.79 Other total reconstruction of breast
Excludes: deep inferior epigastric artery perforator (DIEP) flap, free (85.74)
gluteal artery perforator flap, free (85.76)
lastissimus dorsi myocutaneous flap (85.71)
perforator flap, free (85.70)
superficial inferior epigastric artery (SIEA) flap, free (85.75)
total reconstruction of breast, not otherwise specified (85.70)
transverse rectus abdominis myocutaneous (TRAM) flap, free (85.73)
transverse rectus abdominis myocutaneous (TRAM) flap, pedicled (85.72)
85.8 Other repair and plastic operations on breast
Excludes: that for:
augmentation (85.50-85.54)
reconstruction (85.70-85.76, 85.79)
reduction (85.31-85.32)
85.81 Suture of laceration of breast
85.82 Split-thickness graft to breast
85.83 Full-thickness graft to breast
85.84 Pedicle graft to breast
85.85 Muscle flap graft to breast
85.86 Transposition of nipple
85.87 Other repair or reconstruction of nipple
85.89 Other mammoplasty
85.9 Other operations on the breast
85.91 Aspiration of breast
Excludes: percutaneous biopsy of breast (85.11)
85.92 Injection of therapeutic agent into breast
Excludes: that for augmentation of breast (85.51-85.52)
85.93 Revision of implant of breast
85.94 Removal of implant of breast
85.95 Insertion of breast tissue expander
Insertion (soft tissue) of tissue expander (one or more) under muscle or platysma to develop skin flaps for donor use
85.96 Removal of breast tissue expander
85.99 Other
86 Operations on skin and subcutaneous tissue
Includes: operations on:
hair follicles
male perineum
nails
sebaceous glands
subcutaneous fat pads
sudoriferous glands
superficial fossae
Excludes: those on skin of:
anus (49.01-49.99)
breast (mastectomy site) (85.0-85.99)
ear (18.01-18.9)
eyebrow (08.01-08.99)
eyelid (08.01-08.99)
female perineum (71.01-71.9)
lips (27.0-27.99)
nose (21.00-21.99)
penis (64.0-64.99)
scrotum (61.0-61.99)
vulva (71.01-71.9)
86.0 Incision of skin and subcutaneous tissue
86.01 Aspiration of skin and subcutaneous tissue
Aspiration of:
abscess of nail, skin, or subcutaneous tissue
hematoma of nail, skin, or subcutaneous tissue
seroma of nail, skin, or subcutaneous tissue
86.02 Injection or tattooing of skin lesion or defect
Injection of filling material
Insertion of filling material
Pigmenting of skin of filling material
86.03 Incision of pilonidal sinus or cyst
Excludes: marsupialization (86.21)
86.04 Other incision with drainage of skin and subcutaneous tissue
Excludes: drainage of:
fascial compartments of face and mouth (27.0)
palmar or thenar spac 82.04)
pilonidal sinus or cys 86.03)
86.05 Incision with removal of foreign body or device from skin and subcutaneous tissue
Removal of carotid sinus baroreflex activation device
Removal of loop recorder
Removal of neurostimulator pulse generator (single array, dual array)
Removal of tissue expander(s) from skin or soft tissue other than breast tissue
Excludes: removal of foreign body without incision (98.20-98.29)
86.06 Insertion of totally implantable infusion pump
Code also any associated catheterization
Excludes: insertion of totally implantable vascular access device (86.07)
86.07 Insertion of totally implantable vascular access device [VAD]
Totally implanted port
Excludes: insertion of totally implantable infusion pump (86.06)
86.09 Other incision of skin and subcutaneous tissue
Creation of thalamic stimulator pulse generator pocket, new site
Escharotomy
Exploration:
sinus tract, skin
superficial fossa
Relocation of subcutaneous device pocket NEC
Reopening subcutaneous pocket for device revision without replacement
Undercutting of hair follicle
Excludes: creation of loop recorder pocket, new site and insertion/relocation of device (37.79)
creation of pocket for implantable, patient-activated cardiac event recorder and insertion/relocation of device (37.79)
removal of catheter from cranial cavity (01.27)
that for drainage (86.04)
that of:
cardiac pacemaker pocket, new site (37.79)
fascial compartments of face and mouth (27.0)
86.1 Diagnostic procedures on skin and subcutaneous tissue
86.11 Biopsy of skin and subcutaneous tissue
86.19 Other diagnostic procedures on skin and subcutaneous tissue
Excludes: microscopic examination of specimen from skin and subcutaneous tissue (91.61-91.79)
86.2 Excision or destruction of lesion or tissue of skin and subcutaneous tissue
86.21 Excision of pilonidal cyst or sinus
Marsupialization of cyst
Excludes: incision of pilonidal cyst or sinus (86.03)
86.22 Excisional debridement of wound, infection, or burn
Removal by excision of:
devitalized tissue
necrosis
slough
Excludes: debridement of:
abdominal wall (wound) (54.3)
bone (77.60-77.69)
muscle (83.45)
of hand (82.36)
nail (bed) (fold) (86.27)
nonexcisional debridement of wound, infection, or burn (86.28)
open fracture site (79.60-79.69)
pedicle or flap graft (86.75)
86.23 Removal of nail, nail bed, or nail fold
86.24 Chemosurgery of skin
Chemical peel of skin
86.25 Dermabrasion
That with laser
Excludes: dermabrasion of wound to remove embedded debris (86.28)
86.26 Ligation of dermal appendage
Excludes: excision of preauricula appendage (18.29)
86.27 Debridement of nail, nail bed, or nail fold
Removal of:
necrosis
slough
Excludes: removal of nail, nail bed, or nail fold (86.23)
86.28 Nonexcisional debridement of wound, infection or burn
Debridement NOS
Maggot therapy
Removal of devitalized tissue, necrosis and slough by such methods as:
brushing
irrigation (under pressure)
scrubbing
washing
Water scalpel (jet)
86.3 Other local excision or destruction of lesion or tissue of skin and subcutaneous tissue
Destruction of skin by:
cauterization cryosurgery
fulguration
laser beam
That with Z-plasty
Excludes: adipectomy (86.83)
biopsy of skin (86.11)
wide or radical excision of skin (86.4)
Z-plasty without excision (86.84)
86.4 Radical excision of skin lesion
Wide excision of skin lesion involving underlying or adjacent structure
Code also any lymph node dissection (40.3-40.5)
86.5 Suture or other closure of skin and subcutaneous tissue
86.51 Replantation of scalp
86.59 Closure of skin and subcutaneous tissue of other sites
Adhesives (surgical) (tissue)
Staples
Sutures
Excludes: application of adhesive strips (butterfly) - omit code
86.6 Free skin graft
Includes: excision of skin for autogenous graft
Excludes: construction or reconstruction of:
penis (64.43-64.44)
trachea (31.75)
vagina (70.61-70.64)
86.60 Free skin graft, not otherwise specified
86.61 Full-thickness skin graft to hand
Excludes: heterograft (86.65)
homograft (86.66)
86.62 Other skin graft to hand
Excludes: heterograft (86.65)
homograft (86.66)
86.63 Full-thickness skin graft to other sites
Excludes: heterograft (86.65)
homograft (86.66)
86.64 Hair transplant
Excludes: hair follicle transplant to eyebrow or eyelash (08.63)
86.65 Heterograft to skin
Pigskin graft
Porcine graft
Excludes: application of dressing only (93.57)
86.66 Homograft to skin
Graft to skin of:
amnionic membrane from donor skin from donor
86.67 Dermal regenerative graft
Artificial skin, NOS
Creation of "neodermis"
Decellularized allodermis
Integumentary matrix implants
Prosthetic implant of dermal layer of skin
Regenerate dermal layer of skin
Excludes: heterograft to skin (86.65)
homograft to skin (86.66)
86.69 Other skin graft to other sites
Excludes: heterograft (86.65)
homograft (86.66)
86.7 Pedicle grafts or flaps
Excludes: construction or reconstruction of:
penis (64.43-64.44)
trachea (31.75)
vagina (70.61-70.64)
86.70 Pedicle or flap graft, not otherwise specified
86.71 Cutting and preparation of pedicle grafts or flaps
Elevation of pedicle from its bed
Flap design and raising
Partial cutting of pedicle or tube
Pedicle delay
Excludes: pollicization or digita transfer (82.61, 82.81)
revision of pedicle (86.75)
86.72 Advancement of pedicle graft
86.73 Attachment of pedicle or flap graft to hand
Excludes: pollicization or digita transfer (82.61, 82.81)
86.74 Attachment of pedicle or flap graft to other sites
Attachment by:
advanced flap
double pedicled flap
pedicle graft
rotating flap
sliding flap
tube graft
86.75 Revision of pedicle or flap graft
Debridement of pedicle or flap graft
Defatting of pedicle or flap graft
86.8 Other repair and reconstruction of skin and subcutaneous tissue
86.81 Repair for facial weakness
86.82 Facial rhytidectomy
Face lift
Excludes: rhytidectomy of eyelid (08.86-08.87)
86.83 Size reduction plastic operation
Liposuction
Reduction of adipose tissue of:
abdominal wall (pendulous)
arms (batwing)
buttock
thighs (trochanteric lipomatosis)
Excludes: breast (85.31-85.32)
86.84 Relaxation of scar or web contracture of skin
Z-plasty of skin
Excludes: Z-plasty with excision of lesio (86.3)
86.85 Correction of syndactyly
86.86 Onychoplasty
86.89 Other repair and reconstruction of skin and subcutaneous tissue
Excludes: mentoplasty (76.67-76.68)
86.9 Other operations on skin and subcutaneous tissue
86.91 Excision of skin for graft
Excision of skin with closure of donor site
Excludes: that with graft at sam operative episode (86.60- 86.69)
86.92 Electrolysis and other epilation of skin
Excludes: epilation of eyelid (08.91-08.93)
86.93 Insertion of tissue expander
Insertion (subcutaneous) (soft tissue) of expander(one or more) in scalp (subgaleal space), face, neck, trunk except breast, and upper and lower extremities for development of skin flaps for donor use
Excludes: flap graft preparation (86.71)
tissue expander, breast (85.95)
86.94 Insertion or replacement of single array neurostimulator pulse generator, not specified as rechargeable
Pulse generator (single array, single channel) for intracranial, spinal, and peripheral neurostimulator
Code also any associated lead implantation (02.93,03.93,04.92)
Excludes: insertion or replacement of single array rechargeable neurostimulator pulse generator (86.97)
86.95 Insertion or replacement of dual array neurostimulator pulse generator, not specified as rechargeable
Pulse generator (dual array, dual channel) for intracranial, spinal, and peripheral neurostimulator
Code also any associated lead implantation (02.93,03.93,04.92)
Excludes: insertion or replacement of dual array rechargeable neurostimulator pulse generator (86.98)
86.96 Insertion or replacement of other neurostimulator pulse generator
Code also any associated lead implantation (02.93,03.93,04.92)
Excludes: insertion of dual array neurostimulator pulse generator (86.95, 86.98)
insertion of single array neurostimulator pulse generator (86.94, 86.97)
86.97 Insertion or replacement of single array rechargeable neurostimulator pulse generator
Rechargeable pulse generator (single array, single channel) for intracranial, spinal, and peripheral neurostimulator
Code also any associated lead implantation (02.93,03.93,04.92)
86.98 Insertion or replacement of dual array rechargeable neurostimulator pulse generator
Rechargeable pulse generator (dual array, dual channel) for intracranial, spinal, and peripheral neurostimulator
Code also any associated lead implantation (02.93,03.93,04.92)
86.99 Other
Excludes: removal of sutures from:
abdomen (97.83)
head and neck (97.38)
thorax (97.43)
trunk NEC (97.84)
wound catheter:
irrigation (96.58)
replacement (97.15)
16. MISCELLANEOUS DIAGNOSTIC AND THERAPEUTIC PROCEDURES (87-99)
87 Diagnostic Radiology
87.0 Soft tissue x-ray of face, head, and neck
Excludes: angiography (88.40-88.68)
87.01 Pneumoencephalogram
87.02 Other contrast radiogram of brain and skull
Pneumocisternogram
Pneumoventriculogram
Posterior fossa myelogram
87.03 Computerized axial tomography of head
C.A.T. scan of head
87.04 Other tomography of head
87.05 Contrast dacryocystogram
87.06 Contrast radiogram of nasopharynx
87.07 Contrast laryngogram
87.08 Cervical lymphangiogram
87.09 Other soft tissue x-ray of face, head, and neck
Noncontrast x-ray of:
adenoid
larynx
nasolacrimal duct
nasopharynx
salivary gland
thyroid region
uvula
Excludes: x-ray study of eye (95.14)
87.1 Other x-ray of face, head, and neck
Excludes: angiography (88.40-88.68)
87.11 Full-mouth x-ray of teeth
87.12 Other dental x-ray
Orthodontic cephalogram or cephalometrics
Panorex examination of mandible
Root canal x-ray
87.13 Temporomandibular contrast arthrogram
87.14 Contrast radiogram of orbit
87.15 Contrast radiogram of sinus
87.16 Other x-ray of facial bones
X-ray of:
frontal area
mandible
maxilla
nasal sinuses
nose
orbit
supraorbital area
symphysis menti
zygomaticomaxillary complex
87.17 Other x-ray of skull
Lateral projection of skull
Sagittal projection
Tangential projection
87.2 X-ray of spine
87.21 Contrast myelogram
87.22 Other x-ray of cervical spine
87.23 Other x-ray of thoracic spine
87.24 Other x-ray of lumbosacral spine
Sacrococcygeal x-ray
87.29 Other x-ray of spine
Spinal x-ray NOS
87.3 Soft tissue x-ray of thorax
Excludes: angiocardiography (88.50-88.58)
angiography (88.40-88.68)
87.31 Endotracheal bronchogram
87.32 Other contrast bronchogram
Transcricoid bronchogram
87.33 Mediastinal pneumogram
87.34 Intrathoracic lymphangiogram
87.35 Contrast radiogram of mammary ducts
87.36 Xerography of breast
87.37 Other mammography
87.38 Sinogram of chest wall
Fistulogram of chest wall
87.39 Other soft tissue x-ray of chest wall
87.4 Other x-ray of thorax
Excludes: angiocardiography (88.50-88.58)
angiography (88.40-88.68)
87.41 Computerized axial tomography of thorax
C.A.T. scan of:
heart
thorax
Crystal linea scan of x-ray beam of thorax
Electronic substraction of thorax
Photoelectric response of thorax
Tomography with use of computer, x-rays, and camera of thorax
87.42 Other tomography of thorax
Cardiac tomogram
Excludes: C.A.T. scan of heart (87.41)
87.43 X-ray of ribs, sternum, and clavicle
Examination for:
cervical rib
fracture
87.44 Routine chest x-ray, so described
X-ray of chest NOS
87.49 Other chest x-ray
X-ray of:
bronchus NOS
diaphragm NOS
heart NOS
lung NOS
mediastinum NOS
trachea NOS
87.5 Biliary tract x-ray
87.51 Percutaneous hepatic cholangiogram
87.52 Intravenous cholangiogram
87.53 Intraoperative cholangiogram
87.54 Other cholangiogram
87.59 Other biliary tract x-ray
Cholecystogram
87.6 Other x-ray of digestive system
87.61 Barium swallow
87.62 Upper GI series
87.63 Small bowel series
87.64 Lower GI series
87.65 Other x-ray of intestine
87.66 Contrast pancreatogram
87.69 Other digestive tract x-ray
87.7 X-ray of urinary system
Excludes: angiography of renal vessels (88.45, 88.65)
87.71 Computerized axial tomography of kidney
C.A.T. scan of kidney
87.72 Other nephrotomogram
87.73 Intravenous pyelogram
Diuretic infusion pyelogram
87.74 Retrograde pyelogram
87.75 Percutaneous pyelogram
87.76 Retrograde cystourethrogram
87.77 Other cystogram
87.78 Ileal conduitogram
87.79 Other x-ray of the urinary system
KUB x-ray
87.8 X-ray of female genital organs
87.81 X-ray of gravid uterus
Intrauterine cephalometry by x-ray
87.82 Gas contrast hysterosalpingogram
87.83 Opaque dye contrast hysterosalpingogram
87.84 Percutaneous hysterogram
87.85 Other x-ray of fallopian tubes and uterus
87.89 Other x-ray of female genital organs
87.9 X-ray of male genital organs
87.91 Contrast seminal vesiculogram
87.92 Other x-ray of prostate and seminal vesicles
87.93 Contrast epididymogram
87.94 Contrast vasogram
87.95 Other x-ray of epididymis and vas deferens
87.99 Other x-ray of male genital organs
88 Other diagnostic radiology and related techniques
88.0 Soft tissue x-ray of abdomen
Excludes: angiography (88.40-88.68)
88.01 Computerized axial tomography of abdomen
C.A.T. scan of abdomen
Excludes: C.A.T. scan of kidney (87.71)
88.02 Other abdomen tomography
Excludes: nephrotomogram (87.72)
88.03 Sinogram of abdominal wall
Fistulogram of abdominal wall
88.04 Abdominal lymphangiogram
88.09 Other soft tissue x-ray of abdominal wall
88.1 Other x-ray of abdomen
88.11 Pelvic opaque dye contrast radiography
88.12 Pelvic gas contrast radiography
Pelvic pneumoperitoneum
88.13 Other peritoneal pneumogram
88.14 Retroperitoneal fistulogram
88.15 Retroperitoneal pneumogram
88.16 Other retroperitoneal x-ray
88.19 Other x-ray of abdomen
Flat plate of abdomen
88.2 Skeletal x-ray of extremities and pelvis
Excludes: contrast radiogram of joint (88.32)
88.21 Skeletal x-ray of shoulder and upper arm
88.22 Skeletal x-ray of elbow and forearm
88.23 Skeletal x-ray of wrist and hand
88.24 Skeletal x-ray of upper limb, not otherwise specified
88.25 Pelvimetry
88.26 Other skeletal x-ray of pelvis and hip
88.27 Skeletal x-ray of thigh, knee, and lower leg
88.28 Skeletal x-ray of ankle and foot
88.29 Skeletal x-ray of lower limb, not otherwise specified
88.3 Other x-ray
88.31 Skeletal series
X-ray of whole skeleton
88.32 Contrast arthrogram
Excludes: that of temporomandibular joint (87.13)
88.33 Other skeletal x-ray
Excludes: skeletal x-ray of:
extremities and pelvi 88.21-88.29)
face, head, and neck (87.11-87.17)
spine (87.21-87.29)
thorax (87.43)
88.34 Lymphangiogram of upper limb
88.35 Other soft tissue x-ray of upper limb
88.36 Lymphangiogram of lower limb
88.37 Other soft tissue x-ray of lower limb
Excludes: femoral angiography (88.48,88.66)
88.38 Other computerized axial tomography
C.A.T. scan NOS
Excludes: C.A.T. scan of:
abdomen (88.01)
head (87.03)
heart (87.41)
kidney (87.71)
thorax (87.41)
88.39 X-ray, other and unspecified
88.4 Arteriography using contrast material
Includes: angiography of arteries
arterial puncture for injection of contrast material
radiography of arteries (by fluoroscopy)
retrograde arteriography
The fourth-digit subclassification identifies the site to be viewed, not the site of injection.
Excludes: arteriography using:
radioisotopes or radionuclides (92.01-92.19)
ultrasound (88.71-88.79)
fluorescein angiography of eye (95.12)
88.40 Arteriography using contrast material, unspecified site
88.41 Arteriography of cerebral arteries
Angiography of:
basilar artery
carotid (internal)
posterior cerebral circulation
vertebral artery
88.42 Aortography
Arteriography of aorta and aortic arch
88.43 Arteriography of pulmonary arteries
88.44 Arteriography of other intrathoracic vessels
Excludes: angiocardiography (88.50-88.58)
arteriography of coronary arteries (88.55-88.57)
88.45 Arteriography of renal arteries
88.46 Arteriography of placenta
Placentogram using contrast material
88.47 Arteriography of other intra-abdominal arteries
88.48 Arteriography of femoral and other lower extremity arteries
88.49 Arteriography of other specified sites
88.5 Angiocardiography using contrast material
Includes: arterial puncture and insertion of arterial catheter for injection of contrast material
cineangiocardiography
selective angiocardiography
Code also synchronous cardiac catheterization (37.21-37.23)
Excludes: angiography of pulmonary vessels (88.43, 88.62)
88.50 Angiocardiography, not otherwise specified
88.51 Angiocardiography of venae cavae
Inferior vena cavography
Phlebography of vena cava (inferior) (superior)
88.52 Angiocardiography of right heart structures
Angiocardiography of:
pulmonary valve
right atrium
right ventricle (outflow tract)
Excludes: intra-operative fluorescence vascular angiography (88.59)
that combined with left heart angiocardiography (88.54)
88.53 Angiocardiography of left heart structures
Angiocardiography of:
aortic valve
left atrium
left ventricle (outflow tract)
Excludes: intra-operative fluorescence vascular angiography (88.59)
that combined with right heart angiocardiography (88.54)
88.54 Combined right and left heart angiocardiography
Excludes: intra-operative fluorescence vascular angiography (88.59)
88.55 Coronary arteriography using a single catheter
Coronary arteriography by Sones technique
Direct selective coronary arteriography
using a single catheter
Excludes: intra-operative fluorescence vascular angiography (88.59)
88.56 Coronary arteriography using two catheters
Coronary arteriography by:
Judkins technique
Ricketts and Abrams technique
Direct selective coronary arteriography using two catheters
Excludes: intra-operative fluorescence vascular angiography (88.59)
88.57 Other and unspecified coronary arteriography
Coronary arteriography NOS
Excludes: intra-operative fluorescence vascular angiography (88.59)
88.58 Negative-contrast cardiac roentgenography
Cardiac roentgenography with injection of carbon dioxide
88.59 Intra-operative fluorescence vascular angiography
Intraoperative laser arteriogram (SPY)
SPY arteriogram
SPY arteriography
88.6 Phlebography
Includes: angiography of veins
radiography of veins (by fluoroscopy)
retrograde phlebography
venipuncture for injection of contrast material
venography using contrast material
Note: The fourth-digit subclassification (88.60-88.67) identifies the site to be viewed, not the site of injection.
Excludes: angiography using:
radioisotopes or radionuclides (92.01-92.19)
ultrasound (88.71-88.79)
fluorescein angiography of eye (95.12)
88.60 Phlebography using contrast material, unspecified site
88.61 Phlebography of veins of head and neck using contrast material
88.62 Phlebography of pulmonary veins using contrast material
88.63 Phlebography of other intrathoracic veins using contrast material
88.64 Phlebography of the portal venous system using contrast material
Splenoportogram (by splenic arteriography)
88.65 Phlebography of other intra-abdominal veins using contrast material
88.66 Phlebography of femoral and other lower extremity veins using contrast material
88.67 Phlebography of other specified sites using contrast material
88.68 Impedance phlebography
88.7 Diagnostic ultrasound
Includes: Echography
Non-invasive ultrasound
Ultrasonic angiography
Ultrasonography
Excludes: intravascular imaging (adjunctive) (IVUS) (00.21-00.29)
therapeutic ultrasound (00.01 -00.09)
88.71 Diagnostic ultrasound of head and neck
Determination of midline shift of brain
Echoencephalography
Excludes: eye (95.13)
88.72 Diagnostic ultrasound of heart
Echocardiography
Transesophageal echocardiography
Excludes: echocardiography of heart chambers (37.28)
intracardiac echocardiography (ICE) (37.28)
intravascular (IVUS) imaging of coronary vessels (00.24)
88.73 Diagnostic ultrasound of other sites of thorax
Aortic arch ultrasonography
Breast ultrasonography
Lung ultrasonography
88.74 Diagnostic ultrasound of digestive system
88.75 Diagnostic ultrasound of urinary system
88.76 Diagnostic ultrasound of abdomen and retroperitoneum
88.77 Diagnostic ultrasound of peripheral vascular system
Deep vein thrombosis ultrasonic scanning
Excludes:adjunct vascular system procedures (00.40-00.43)
88.78 Diagnostic ultrasound of gravid uterus
Intrauterine cephalometry:
echo
ultrasonic
Placental localization by ultrasound
88.79 Other diagnostic ultrasound
Ultrasonography of:
multiple sites
nongravid uterus
total body
88.8 Thermography
88.81 Cerebral thermography
88.82 Ocular thermography
88.83 Bone thermography
Osteoarticular thermography
88.84 Muscle thermography
88.85 Breast thermography
88.86 Blood vessel thermography
Deep vein thermography
88.89 Thermography of other sites
Lymph gland thermography
Thermography NOS
88.9 Other diagnostic imaging
88.90 Diagnostic imaging, not elsewhere classified
88.91 Magnetic resonance imaging of brain and brain stem
Excludes: intraoperative magnetic resonance imaging (88.96)
laser interstitial thermal therapy [LITT] of lesion or tissue of brain under guidance (17.61)
real-time magnetic resonance imaging (88.96)
88.92 Magnetic resonance imaging of chest and myocardium
For evaluation of hilar and mediastinal lymphadenopathy
Excludes: laser interstitial thermal therapy [LITT] of lesion or tissue of breast under guidance (17.69)
laser interstitial thermal therapy [LITT] of lesion or tissue of lung under guidance (17.69)
88.93 Magnetic resonance imaging of spinal canal
Spinal cord levels:
cervical
thoracic
lumbar (lumbosacral)
Spinal cord
Spine
88.94 Magnetic resonance imaging of musculoskeletal
Bone marrow blood supply
Extremities (upper) (lower)
88.95 Magnetic resonance imaging of pelvis, prostate, and bladder
Excludes: laser interstitial thermal therapy [LITT] of lesion or tissue of prostate under guidance (17.69)
88.96 Other intraoperative magnetic resonance imaging
iMRI
Real-time magnetic resonance imaging
88.97 Magnetic resonance imaging of other and unspecified sites
Abdomen
Eye orbit
Face
Neck
Excludes: laser interstitial thermal therapy [LITT] of lesion or tissue of other and unspecified site under guidance (17.69)
88.98 Bone mineral density studies
Dual photon absorptiometry
Quantitative computed tomography (CT)
studies
Radiographic densitometry
Single photon absorptiometry
89 Interview, evaluation, consultation, and examination
89.0 Diagnostic interview, consultation, and evaluation
Excludes: psychiatric diagnostic interview (94.11-94.19)
89.01 Interview and evaluation, described as brief
Abbreviated history and evaluation
89.02 Interview and evaluation, described as limited
Interval history and evaluation
89.03 Interview and evaluation, described as comprehensive
History and evaluation of new problem
89.04 Other interview and evaluation
89.05 Diagnostic interview and evaluation, not otherwise specified
89.06 Consultation, described as limited
Consultation on a single organ system
89.07 Consultation, described as comprehensive
89.08 Other consultation
89.09 Consultation, not otherwise specified
89.1 Anatomic and physiologic measurements and manual examinations -- nervous system and sense organs
Excludes: ear examination (95.41-95.49)
eye examination (95.01-95.26)
the listed procedures when done as part of a general physical examination (89.7)
89.10 Intracarotid amobarbital test
Wada test
89.11 Tonometry
89.12 Nasal function study
Rhinomanometry
89.13 Neurologic examination
89.14 Electroencephalogram
Excludes: that with polysomnogram (89.17)
89.15 Other nonoperative neurologic function tests
89.16 Transillumination of newborn skull
89.17 Polysomnogram
Sleep recording
89.18 Other sleep disorder function tests
Multiple sleep latency test [MSLT]
89.19 Video and radio-telemetered electroencephalographic monitoring
Radiographic EEG monitoring
Video EEG monitoring
89.2 Anatomic and physiologic measurements and manual examinations -- genitourinary system
Excludes: the listed procedures when done as part of a general physical examination (89.7)
89.21 Urinary manometry
Manometry through:
indwelling ureteral catheter
nephrostomy
pyelostomy
ureterostomy
89.22 Cystometrogram
89.23 Urethral sphincter electromyogram
89.24 Uroflowmetry [UFR]
89.25 Urethral pressure profile [UPP]
89.26 Gynecological examination
Pelvic examination
89.29 Other nonoperative genitourinary system measurements
Bioassay of urine
Renal clearance
Urine chemistry
89.3 Other anatomic and physiologic measurements and manual examinations
Excludes: the listed procedures when done as part of a general physical examination (89.7)
89.31 Dental examination
Oral mucosal survey
Periodontal survey
89.32 Esophageal manometry
89.33 Digital examination of enterostomy stoma
Digital examination of colostomy stoma
89.34 Digital examination of rectum
89.35 Transillumination of nasal sinuses
89.36 Manual examination of breast
89.37 Vital capacity determination
Excludes: endoscopic pulmonary airway flow measurement (33.72)
89.38 Other nonoperative respiratory measurements
Plethysmography for measurement of respiratory function
Thoracic impedance plethysmography
Excludes: endoscopic pulmonary airway flow measurement (33.72)
89.39 Other nonoperative measurements and examinations
14 C-Urea breath test
Basal metabolic rate [BMR]
Gastric:
analysis
function NEC
Excludes: body measurement (93.07)
cardiac tests (89.41-89.69)
fundus photography (95.11)
limb length measurement (93.06)
89.4 Cardiac stress tests, pacemaker and defibrillator checks
89.41 Cardiovascular stress test using treadmill
89.42 Masters' two-step stress test
89.43 Cardiovascular stress test using bicycle ergometer
89.44 Other cardiovascular stress test
Thallium stress test with or without transesophageal pacing
89.45 Artificial pacemaker rate check
Artificial pacemaker function check NOS
Bedside device check of pacemaker or cardiac resynchronization pacemaker [CRT-P]
Interrogation only without arrhythmia induction
Excludes: catheter based invasive electrophysiologic testing (37.26)
noninvasive programmed electrical stimulation [NIPS] (arrhythmia induction) (37.20)
89.46 Artificial pacemaker artifact wave form check
89.47 Artificial pacemaker electrode impedance check
89.48 Artificial pacemaker voltage or amperage threshold check
89.49 Automatic implantable cardioverter/defibrillator (AICD) check
Bedside check of an AICD or cardiac resynchronization defibrillator [CRT-D]
Checking pacing thresholds of device
Interrogation only without arrhythmia induction
Excludes: catheter based invasive electrophysiologic testing (37.26)
noninvasive programmed electrical stimulation [NIPS] (arrhythmia induction) (37.20)
89.5 Other nonoperative cardiac and vascular diagnostic procedures
Excludes: fetal EKG (75.32)
89.50 Ambulatory cardiac monitoring
Analog devices [Holter-type]
89.51 Rhythm electrocardiogram
Rhythm EKG (with one to three leads)
89.52 Electrocardiogram
ECG NOS
EKG (with 12 or more leads)
89.53 Vectorcardiogram (with ECG)
89.54 Electrographic monitoring
Telemetry
Excludes: ambulatory cardiac monitoring (89.50)
electrographic monitoring durin surgery -- omit code
89.55 Phonocardiogram with ECG lead
89.56 Carotid pulse tracing with ECG lead
Excludes: oculoplethysmography (89.58)
89.57 Apexcardiogram (with ECG lead)
89.58 Plethysmogram
Penile plethysmography with nerve stimulation
Excludes: plethysmography (for):
measurement of respiratory function (89.38)
thoracic impedance (89.38)
89.59 Other nonoperative cardiac and vascular measurements
89.6 Circulatory monitoring
Excludes: electrocardiographic monitoring during surgery -- omit code
implantation or replacement of subcutaneous device for intracardiac hemodynamic monitoring (00.57)
insertion or replacement of implantable pressure sensor (lead) for intracardiac hemodynamic monitoring (00.56)
89.60 Continuous intra-arterial blood gas monitoring
Insertion of blood gas monitoring system and continuous monitoring of blood gases through an intra-arterial sensor
89.61 Systemic arterial pressure monitoring
Excludes: intra-aneurysm sac pressure monitoring (intraoperative) (00.58)
intravascular pressure measurement of intrathoracic arteries (00.67)
intravascular pressure measurement of peripheral arteries (00.68)
89.62 Central venous pressure monitoring
Excludes: intravascular pressure measurement, other specified and unspecified vessels (00.69)
89.63 Pulmonary artery pressure monitoring
Excludes: pulmonary artery wedge monitoring (89.64)
89.64 Pulmonary artery wedge monitoring
Pulmonary capillary wedge [PCW] monitoring
Swan-Ganz catheterization
89.65 Measurement of systemic arterial blood gases
Excludes: continuous intra-arterial blood gas monitoring (89.60)
89.66 Measurement of mixed venous blood gases
89.67 Monitoring of cardiac output by oxygen consumption technique
Fick method
89.68 Monitoring of cardiac output by other technique
Cardiac output monitor by thermodilution indicator
89.69 Monitoring of coronary blood flow
Coronary blood flow monitoring by coincidence counting technique
Excludes: intravascular pressure measurement of coronary arteries (00.59)
89.7 General physical examination
89.8 Autopsy
90 Microscopic examination-I
The following fourth-digit subclassification is for use with categories in section 90 to identify type of examination:
1 bacterial smear
2 culture
3 culture and sensitivity
4 parasitology
5 toxicology
6 cell block and Papanicolaou smear
9 other microscopic examination
90.0 Microscopic examination of specimen from nervous system and of spinal fluid
90.1 Microscopic examination of specimen from endocrine gland, not elsewhere classified
90.2 Microscopic examination of specimen from eye
90.3 Microscopic examination of specimen from ear, nose, throat, and larynx
90.4 Microscopic examination of specimen from trachea, bronchus, pleura, lung, and other thoracic specimen, and of sputum
90.5 Microscopic examination of blood
90.6 Microscopic examination of specimen from spleen and of bone marrow
90.7 Microscopic examination of specimen from lymph node and of lymph
90.8 Microscopic examination of specimen from upper gastrointestinal tract and of vomitus
90.9 Microscopic examination of specimen from lower gastrointestinal tract and of stool
91 Microscopic examination-II
The following fourth-digit subclassification is for use with categories in section 91 to identify type of examination
1 bacterial smear
2 culture
3 culture and sensitivity
4 parasitology
5 toxicology
6 cell block and Papanicolaou smear
9 other microscopic examination
91.0 Microscopic examination of specimen from liver, biliary tract, and pancreas
91.1 Microscopic examination of peritoneal and retroperitoneal specimen
91.2 Microscopic examination of specimen from kidney, ureter, perirenal and periureteral tissue
91.3 Microscopic examination of specimen from bladder, urethra, prostate, seminal vesicle, perivesical tissue, and of urine and semen
91.4 Microscopic examination of specimen from female genital tract
Amnionic sac
Fetus
91.5 Microscopic examination of specimen from musculoskeletal system and of joint fluid
Microscopic examination of:
bone
bursa
cartilage
fascia
ligament
muscle
synovial membrane
tendon
91.6 Microscopic examination of specimen from skin and other integument
Microscopic examination of:
hair
nails
skin
Excludes: mucous membrane -- code to organ site
that of operative wound (91.71-91.79)
91.7 Microscopic examination of specimen from operative wound
91.8 Microscopic examination of specimen from other site
91.9 Microscopic examination of specimen from unspecified site
92 Nuclear medicine
92.0 Radioisotope scan and function study
92.01 Thyroid scan and radioisotope function studies
Iodine-131 uptake
Protein-bound iodine
Radio-iodine uptake
92.02 Liver scan and radioisotope function study
92.03 Renal scan and radioisotope function study
Renal clearance study
92.04 Gastrointestinal scan and radioisotope function study
Radio-cobalt B12 Schilling test
Radio-iodinated triolein study
92.05 Cardiovascular and hematopoietic scan and radioisotope function study
Bone marrow scan or function study
Cardiac output scan or function study
Circulation time scan or function study
Radionuclide cardiac ventriculogram scan or function study
Spleen scan or function study
92.09 Other radioisotope function studies
92.1 Other radioisotope scan
92.11 Cerebral scan
Pituitary
92.12 Scan of other sites of head
Excludes: eye (95.16)
92.13 Parathyroid scan
92.14 Bone scan
92.15 Pulmonary scan
92.16 Scan of lymphatic system
92.17 Placental scan
92.18 Total body scan
92.19 Scan of other sites
92.2 Therapeutic radiology and nuclear medicine
Excludes: that for:
ablation of pituitary gland (07.64-07.69)
destruction of chorioretinal lesion (14.26-14.27)
92.20 Infusion of liquid brachytherapy radioisotope
I-125 radioisotope
Intracavitary brachytherapy
Includes: removal of radioisotope
92.21 Superficial radiation
Contact radiation [up to 150 KVP]
92.22 Orthovoltage radiation
Deep radiation [200-300 KVP]
92.23 Radioisotopic teleradiotherapy
Teleradiotherapy using:
cobalt-60
iodine-125
radioactive cesium
92.24 Teleradiotherapy using photons
Megavoltage NOS
Supervoltage NOS
Use of:
Betatron
linear accelerator
92.25 Teleradiotherapy using electrons
Beta particles
Excludes: intra-operative electron radiation therapy (92.41)
92.26 Teleradiotherapy of other particulate radiation
Neutrons
Protons NOS
92.27 Implantation or insertion of radioactive elements
Intravascular brachytherapy
Code also incision of site
Excludes: infusion of liquid brachytherapy radioisotope (92.20)
92.28 Injection or instillation of radioisotopes
Injection or infusion of radioimmunoconjugate
Intracavitary injection or instillation
Intravenous injection or instillation
Iodine-131 [I-131] tositumomab
Radioimmunotherapy
Ytrium-90 [Y-90] ibritumomab tiuxetan
Excludes: infusion of liquid brachytherapy radioisotope (92.20)
92.29 Other radiotherapeutic procedure
92.3 Stereotactic radiosurgery
Code also stereotactic head frame application (93.59)
Excludes: stereotactic biopsy
92.30 Stereotactic radiosurgery, not otherwise specified
92.31 Single source photon radiosurgery
High energy x-rays
Linear accelerator (LINAC)
92.32 Multi-source photon radiosurgery
Cobalt 60 radiation
Gamma irradiation
92.33 Particulate radiosurgery
Particle beam radiation (cyclotron)
Proton accerlerator
92.39 Stereotactic radiosurgery, not elsewhere classified
92.4 Intra-operative radiation procedures
92.41 Intra-operative electron radiation therapy
IOERT
That using a mobile linear accelerator
93 Physical therapy, respiratory therapy, rehabilitation, and related procedures
93.0 Diagnostic physical therapy
93.01 Functional evaluation
93.02 Orthotic evaluation
93.03 Prosthetic evaluation
93.04 Manual testing of muscle function
93.05 Range of motion testing
93.06 Measurement of limb length
93.07 Body measurement
Girth measurement
Measurement of skull circumference
93.08 Electromyography
Excludes: eye EMG (95.25)
that with polysomnogram (89.17)
urethral sphincter EMG (89.23)
93.09 Other diagnostic physical therapy procedure
93.1 Physical therapy exercises
93.11 Assisting exercise
Excludes: assisted exercise in pool (93.31)
93.12 Other active musculoskeletal exercise
93.13 Resistive exercise
93.14 Training in joint movements
93.15 Mobilization of spine
93.16 Mobilization of other joints
Excludes: manipulation o temporomandibular joint (76.95)
93.17 Other passive musculoskeletal exercise
93.18 Breathing exercise
93.19 Exercise, not elsewhere classified
93.2 Other physical therapy musculoskeletal manipulation
93.21 Manual and mechanical traction
Excludes: skeletal traction (93.43-93.44)
skin traction (93.45-93.46)
spinal traction (93.41-93.42)
93.22 Ambulation and gait training
93.23 Fitting of orthotic device
93.24 Training in use of prosthetic or orthotic device
Training in crutch walking
93.25 Forced extension of limb
93.26 Manual rupture of joint adhesions
93.27 Stretching of muscle or tendon
93.28 Stretching of fascia
93.29 Other forcible correction of deformity
93.3 Other physical therapy therapeutic procedures
93.31 Assisted exercise in pool
93.32 Whirlpool treatment
93.33 Other hydrotherapy
93.34 Diathermy
93.35 Other heat therapy
Acupuncture with smouldering moxa
Hot packs
Hyperthermia NEC
Infrared irradiation
Moxibustion
Paraffin bath
Excludes: hyperthermia for treatment of cancer (99.85)
93.36 Cardiac retraining
93.37 Prenatal training
Training for natural childbirth
93.38 Combined physical therapy without mention of the components
93.39 Other physical therapy
93.4 Skeletal traction and other traction
93.41 Spinal traction using skull device
Traction using:
caliper tongs
Crutchfield tongs
halo device
Vinke tongs
Excludes: insertion of tongs or halo traction device (02.94)
93.42 Other spinal traction
Cotrel's traction
Excludes: cervical collar (93.52)
93.43 Intermittent skeletal traction
93.44 Other skeletal traction
Bryant's traction
Dunlop's traction
Lyman Smith traction
Russell's traction
93.45 Thomas' splint traction
93.46 Other skin traction of limbs
Adhesive tape traction
Boot traction
Buck's traction
Gallows traction
93.5 Other immobilization, pressure, and attention to wound
Excludes: external fixator device (84.71-84.73)
wound cleansing (96.58-96.59)
93.51 Application of plaster jacket
Excludes: Minerva jacket (93.52)
93.52 Application of neck support
Application of:
cervical collar
Minerva jacket
molded neck support
93.53 Application of other cast
93.54 Application of splint
Plaster splint
Tray splint
Excludes: periodontal splint (24.7)
93.55 Dental wiring
Excludes: that for orthodontia (24.7)
93.56 Application of pressure dressing
Application of:
Gibney bandage
Robert Jones' bandage
Shanz dressing
93.57 Application of other wound dressing
Porcine wound dressing
93.58 Application of pressure trousers
Application of:
anti-shock trousers
MAST trousers
vasopneumatic device
93.59 Other immobilization, pressure, and attention to wound
Elastic stockings
Electronic gaiter
Intermittent pressure device
Oxygenation of wound (hyperbaric)
Stereotactic head frame application
Strapping (non-traction)
Velpeau dressing
93.6 Osteopathic manipulative treatment
93.61 Osteopathic manipulative treatment for general mobilization
General articulatory treatment
93.62 Osteopathic manipulative treatment using high- velocity, low-amplitude forces
Thrusting forces
93.63 Osteopathic manipulative treatment using low- velocity, high-amplitude forces
Springing forces
93.64 Osteopathic manipulative treatment using isotonic, isometric forces
93.65 Osteopathic manipulative treatment using indirect forces
93.66 Osteopathic manipulative treatment to move tissue fluids
Lymphatic pump
93.67 Other specified osteopathic manipulative treatment
93.7 Speech and reading rehabilitation and rehabilitation of the blind
93.71 Dyslexia training
93.72 Dysphasia training
93.73 Esophageal speech training
93.74 Speech defect training
93.75 Other speech training and therapy
93.76 Training in use of lead dog for the blind
93.77 Training in braille or Moon
93.78 Other rehabilitation for the blind
93.8 Other rehabilitation therapy
93.81 Recreation therapy
Diversional therapy
Play therapy
Excludes: play psychotherapy (94.36)
93.82 Educational therapy
Education of bed-bound children
Special schooling for the handicapped
93.83 Occupational therapy
Daily living activities therapy
Excludes: training in activities of daily living for the blind (93.78)
93.84 Music therapy
93.85 Vocational rehabilitation
Sheltered employment
Vocational:
assessment
retraining
training
93.89 Rehabilitation, not elsewhere classified
93.9 Respiratory therapy
Excludes: insertion of airway (96.01-96.05)
other continuous invasive (through endotracheal tube or tracheostomy) mechanical ventilation (96.70-96.72)
93.90 Non-invasive mechanical ventilation
Bi-level airway pressure
BiPAP without (delivery through) endotracheal tube or tracheostomy
CPAP without (delivery through) endotracheal tube or tracheostomy
Mechanical ventilation NOS
Non-invasive positive pressure (NIPPV)
Non-invasive PPV
NPPV
That delivered by non-invasive interface:
face mask
nasal mask
nasal pillow
oral mouthpiece
oronasal mask
Excludes: invasive (through endotracheal tube or tracheostomy) continuous mechanical ventilation (96.70-96.72)
Note: Patients admitted on non-invasive mechanical ventilation that subsequently require invasive mechanical ventilation; code both types of mechanical ventilation.
93.91 Intermittent positive pressure breathing [IPPB]
93.93 Nonmechanical methods of resuscitation
Artificial respiration
Manual resuscitation
Mouth-to-mouth resuscitation
93.94 Respiratory medication administered by nebulizer
Mist therapy
93.95 Hyperbaric oxygenation
Excludes: oxygenation of wound (93.59)
93.96 Other oxygen enrichment
Catalytic oxygen therapy
Cytoreductive effect
Oxygenators
Oxygen therapy
Excludes: oxygenation of wound (93.59)
SuperSaturated oxygen therapy (00.49)
93.97 Decompression chamber
93.98 Other control of atmospheric pressure and composition
Antigen-free air conditioning
Helium therapy
Excludes: inhaled nitric oxide therapy (INO) (00.12)
93.99 Other respiratory procedures
Continuous negative pressure ventilation [CNP]
Postural drainage
94 Procedures related to the psyche
94.0 Psychologic evaluation and testing
94.01 Administration of intelligence test
Administration of:
Stanford-Binet
Wechsler Adult Intelligence Scale
Wechsler Intelligence Scale for Children
94.02 Administration of psychologic test
Administration of:
Bender Visual-Motor Gestalt Test
Benton Visual Retention Test
Minnesota Multiphasic Personality Inventory
Wechsler Memory Scale
94.03 Character analysis
94.08 Other psychologic evaluation and testing
94.09 Psychologic mental status determination, not otherwise specified
94.1 Psychiatric interviews, consultations, and evaluations
94.11 Psychiatric mental status determination
Clinical psychiatric mental status determination
Evaluation for criminal responsibility
Evaluation for testimentary capacity
Medicolegal mental status determination
Mental status determination NOS
94.12 Routine psychiatric visit, not otherwise specified
94.13 Psychiatric commitment evaluation
Pre-commitment interview
94.19 Other psychiatric interview and evaluation
Follow-up psychiatric interview NOS
94.2 Psychiatric somatotherapy
94.21 Narcoanalysis
Narcosynthesis
94.22 Lithium therapy
94.23 Neuroleptic therapy
94.24 Chemical shock therapy
94.25 Other psychiatric drug therapy
94.26 Subconvulsive electroshock therapy
94.27 Other electroshock therapy
Electroconvulsive therapy (ECT)
EST
94.29 Other psychiatric somatotherapy
94.3 Individual psychotherapy
94.31 Psychoanalysis
94.32 Hypnotherapy
Hypnodrome
Hypnosis
94.33 Behavior therapy
Aversion therapy
Behavior modification
Desensitization therapy
Extinction therapy
Relaxation training
Token economy
94.34 Individual therapy for psychosexual dysfunction
Excludes: that performed in group setting (94.41)
94.35 Crisis intervention
94.36 Play psychotherapy
94.37 Exploratory verbal psychotherapy
94.38 Supportive verbal psychotherapy
94.39 Other individual psychotherapy
Biofeedback
94.4 Other psychotherapy and counselling
94.41 Group therapy for psychosexual dysfunction
94.42 Family therapy
94.43 Psychodrama
94.44 Other group therapy
94.45 Drug addiction counselling
94.46 Alcoholism counselling
94.49 Other counselling
94.5 Referral for psychologic rehabilitation
94.51 Referral for psychotherapy
94.52 Referral for psychiatric aftercare:
That in:
halfway house
outpatient (clinic) facility
94.53 Referral for alcoholism rehabilitation
94.54 Referral for drug addiction rehabilitation
94.55 Referral for vocational rehabilitation
94.59 Referral for other psychologic rehabilitation
94.6 Alcohol and drug rehabilitation and detoxification
94.61 Alcohol rehabilitation
94.62 Alcohol detoxification
94.63 Alcohol rehabilitation and detoxification
94.64 Drug rehabilitation
94.65 Drug detoxification
94.66 Drug rehabilitation and detoxification
94.67 Combined alcohol and drug rehabilitation
94.68 Combined alcohol and drug detoxification
94.69 Combined alcohol and drug rehabilitation and detoxification
95 Ophthalmologic and otologic diagnosis and treatment
95.0 General and subjective eye examination
95.01 Limited eye examination
Eye examination with prescription of spectacles
95.02 Comprehensive eye examination
Eye examination covering all aspects of the visual system
95.03 Extended ophthalmologic work-up
Examination (for):
glaucoma
neuro-ophthalmology
retinal disease
95.04 Eye examination under anesthesia
Code also type of examination
95.05 Visual field study
95.06 Color vision study
95.07 Dark adaptation study
95.09 Eye examination, not otherwise specified
Vision check NOS
95.1 Examinations of form and structure of eye
95.11 Fundus photography
95.12 Fluorescein angiography or angioscopy of eye
95.13 Ultrasound study of eye
95.14 X-ray study of eye
95.15 Ocular motility study
95.16 P32 and other tracer studies of eye
95.2 Objective functional tests of eye
Excludes: that with polysomnogram (89.17)
95.21 Electroretinogram [ERG]
95.22 Electro-oculogram [EOG]
95.23 Visual evoked potential [VEP]
95.24 Electronystagmogram [ENG]
95.25 Electromyogram of eye [EMG]
95.26 Tonography, provocative tests, and other glaucoma testing
95.3 Special vision services
95.31 Fitting and dispensing of spectacles
95.32 Prescription, fitting, and dispensing of contact lens
95.33 Dispensing of other low vision aids
95.34 Ocular prosthetics
95.35 Orthoptic training
95.36 Ophthalmologic counselling and instruction
Counselling in:
adaptation to visual loss
use of low vision aids
95.4 Nonoperative procedures related to hearing
95.41 Audiometry
Békésy 5-tone audiometry
Impedance audiometry
Stapedial reflex response
Subjective audiometry
Tympanogram
95.42 Clinical test of hearing
Tuning fork test
Whispered speech test
95.43 Audiological evaluation
Audiological evaluation by:
Bárány noise machine
blindfold test
delayed feedback
masking
Weber lateralization
95.44 Clinical vestibular function tests
Thermal test of vestibular function
95.45 Rotation tests
Bárány chair
95.46 Other auditory and vestibular function tests
95.47 Hearing examination, not otherwise specified
95.48 Fitting of hearing aid
Excludes: implantation of electromagnetic hearing device (20.95)
95.49 Other nonoperative procedures related to hearing
Adjustment (external components) of cochlear prosthetic device
96 Nonoperative intubation and irrigation
96.0 Nonoperative intubation of gastrointestinal and respiratory tracts
96.01 Insertion of nasopharyngeal airway
96.02 Insertion of oropharyngeal airway
96.03 Insertion of esophageal obturator airway
96.04 Insertion of endotracheal tube
96.05 Other intubation of respiratory tract
Excludes: endoscopic insertion or replacement of bronchial device or substance (33.71, 33.79)
96.06 Insertion of Sengstaken tube
Esophageal tamponade
96.07 Insertion of other (naso-)gastric tube
Intubation for decompression
Excludes: that for enteral infusion of nutritional substance (96.6)
96.08 Insertion of (naso-)intestinal tube
Miller-Abbott tube (for decompression)
96.09 Insertion of rectal tube
Replacement of rectal tube
96.1 Other nonoperative insertion
Excludes: nasolacrimal intubation (09.44)
96.11 Packing of external auditory canal
96.14 Vaginal packing
96.15 Insertion of vaginal mold
96.16 Other vaginal dilation
96.17 Insertion of vaginal diaphragm
96.18 Insertion of other vaginal pessary
96.19 Rectal packing
96.2 Nonoperative dilation and manipulation
96.21 Dilation of frontonasal duct
96.22 Dilation of rectum
96.23 Dilation of anal sphincter
96.24 Dilation and manipulation of enterostomy stoma
96.25 Therapeutic distention of bladder
Intermittent distention of bladder
96.26 Manual reduction of rectal prolapse
96.27 Manual reduction of hernia
96.28 Manual reduction of enterostomy prolapse
96.29 Reduction of intussusception of alimentary tract
With:
fluoroscopy
ionizing radiation enema
ultrasonography guidance
Hydrostatic reduction
Pneumatic reduction
Excludes: intra-abdominal manipulation of intestine, not otherwise specified (46.80)
96.3 Nonoperative alimentary tract irrigation, cleaning, and local instillation
96.31 Gastric cooling
Gastric hypothermia
96.32 Gastric freezing
96.33 Gastric lavage
96.34 Other irrigation of (naso-)gastric tube
96.35 Gastric gavage
96.36 Irrigation of gastrostomy or enterostomy
96.37 Proctoclysis
96.38 Removal of impacted feces
Removal of impaction:
by flushing manually
96.39 Other transanal enema
Rectal irrigation
Excludes: reduction of intussusception of alimentary tract by ionizing radiation enema (96.29)
96.4 Nonoperative irrigation, cleaning, and local instillation of other digestive and genitourinary organs
96.41 Irrigation of cholecystostomy and other biliary tube
96.42 Irrigation of pancreatic tube
96.43 Digestive tract instillation, except gastric gavage
96.44 Vaginal douche
96.45 Irrigation of nephrostomy and pyelostomy
96.46 Irrigation of ureterostomy and ureteral catheter
96.47 Irrigation of cystostomy
96.48 Irrigation of other indwelling urinary catheter
96.49 Other genitourinary instillation
Insertion of prostaglandin suppository
96.5 Other nonoperative irrigation and cleaning
96.51 Irrigation of eye
Irrigation of cornea
Excludes: irrigation with removal of foreign body (98.21)
96.52 Irrigation of ear
Irrigation with removal of cerumen
96.53 Irrigation of nasal passages
96.54 Dental scaling, polishing, and debridement
Dental prophylaxis
Plaque removal
96.55 Tracheostomy toilette
96.56 Other lavage of bronchus and trachea
Excludes: diagnostic bronchoalveolar lavage (BAL)(33.24)
whole lung lavage (33.99)
96.57 Irrigation of vascular catheter
96.58 Irrigation of wound catheter
96.59 Other irrigation of wound
Wound cleaning NOS
Excludes: debridement (86.22, 86.27-86.28)
96.6 Enteral infusion of concentrated nutritional substances
96.7 Other continuous invasive mechanical ventilation
Includes: BiPAP delivered through endotracheal tube or tracheostomy (invasive interface)
CPAP delivered through endotracheal tube or tracheostomy (invasive interface)
Endotracheal respiratory assistance
Invasive positive pressure ventilation [IPPV]
Mechanical ventilation through invasive interface
That by tracheostomy
Weaning of an intubated (endotracheal tube) patient
Excludes: non-invasive bi-level positive airway pressure [BiPAP] (93.90)
continuous negative pressure ventilation [CNP] (iron lung) (cuirass) (93.99)
non-invasive continuous positive airway pressure [CPAP] (93.90)
intermittent positive pressure breathing [IPPB] (93.91)
non-invasive positive pressure (NIPPV) (93.90)
that by face mask (93.90-93.99)
that by nasal cannula (93.90-93.99)
that by nasal catheter (93.90-93.99)
Code also any associated:
endotracheal tube insertion (96.04)
tracheostomy (31.1-31.29)
Note: Endotracheal Intubation
To calculate the number of hours (duration) of continuous mechanical ventilation during a hospitalization, begin the count from the start of the (endotracheal) intubation. The duration ends with (endotracheal) extubation.
If a patient is intubated prior to admission, begin counting the duration from the time of the admission. If a patient is transferred (discharged) while intubated, the duration would end at the time of transfer (discharge).
For patients who begin on (endotracheal) intubation and subsequently have a tracheostomy performed for mechanical ventilation, the duration begins with the (endotracheal) intubation and ends when the mechanical ventilation is turned off (after the weaning period).
Tracheostomy
To calculate the number of hours of continuous mechanical ventilation during a hospitalization, begin counting the duration when mechanical ventilation is started. The duration ends when the mechanical ventilator is turned off (after the weaning period).
If a patient has received a tracheostomy prior to admission and is on mechanical ventilation at the time of admission, begin counting the duration from the time of admission. If a patient is transferred (discharged) while still on mechanical ventilation via tracheostomy, the duration would end at the time of the transfer (discharge).
96.70 Continuous invasive mechanical ventilation of unspecified duration
Invasive mechanical ventilation NOS
96.71 Continuous invasive mechanical ventilation for less than 96 consecutive hours
96.72 Continuous invasive mechanical ventilation for 96 consecutive hours or more
97 Replacement and removal of therapeutic appliances
97.0 Nonoperative replacement of gastrointestinal appliance
97.01 Replacement of (naso-)gastric or esophagostomy tube
97.02 Replacement of gastrostomy tube
97.03 Replacement of tube or enterostomy device of small intestine
97.04 Replacement of tube or enterostomy device of large intestine
97.05 Replacement of stent (tube) in biliary or pancreatic duct
97.1 Nonoperative replacement of musculoskeletal and integumentary system appliance
97.11 Replacement of cast on upper limb
97.12 Replacement of cast on lower limb
97.13 Replacement of other cast
97.14 Replacement of other device for musculoskeletal immobilization
Splinting
Strapping
97.15 Replacement of wound catheter
97.16 Replacement of wound packing or drain
Excludes: repacking of:
dental wound (97.22)
vulvar wound (97.26)
97.2 Other nonoperative replacement
97.21 Replacement of nasal packing
97.22 Replacement of dental packing
97.23 Replacement of tracheostomy tube
97.24 Replacement and refitting of vaginal diaphragm
97.25 Replacement of other vaginal pessary
97.26 Replacement of vaginal or vulvar packing or drain
97.29 Other nonoperative replacements
97.3 Nonoperative removal of therapeutic device from head and neck
97.31 Removal of eye prosthesis
Excludes: removal of ocular implan (16.71)
removal of orbital implan (16.72)
97.32 Removal of nasal packing
97.33 Removal of dental wiring
97.34 Removal of dental packing
97.35 Removal of dental prosthesis
97.36 Removal of other external mandibular fixation device
97.37 Removal of tracheostomy tube
97.38 Removal of sutures from head and neck
97.39 Removal of other therapeutic device from head and neck
Excludes: removal of skull tongs (02.94)
97.4 Nonoperative removal of therapeutic device from thorax
97.41 Removal of thoracotomy tube or pleural cavity drain
97.42 Removal of mediastinal drain
97.43 Removal of sutures from thorax
97.44 Nonoperative removal of heart assist system
Explantation [removal] of circulatory assist device
Explantation [removal] of percutaneous external heart assist device
Intra-aortic balloon pump [IABP]
Removal of extrinsic heart assist device
Removal of pVAD
Removal of percutaneous heart assist device
97.49 Removal of other device from thorax
Excludes: Endoscopic removal of bronchial device(s) or substances (33.78)
97.5 Nonoperative removal of therapeutic device from digestive system
97.51 Removal of gastrostomy tube
97.52 Removal of tube from small intestine
97.53 Removal of tube from large intestine or appendix
97.54 Removal of cholecystostomy tube
97.55 Removal of T-tube, other bile duct tube, or liver tube
Removal of bile duct stent
97.56 Removal of pancreatic tube or drain