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1 CHA/P Codes License for Use of Current Procedural Terminology, Fourth Edition (CPT) Notice The CPT code descriptions herein have been shortened to 28 characters or less to comply with copyright restrictions. Please refer to the current CPT for complete descriptions. CPT is copyright 2010 American Medical Association (AMA). All rights reserved. CPT is a registered trademark of the American Medical Association. Applicable FARS/DFARS restrictions apply to government use. You, your employees and agents are authorized to use CPT internally within your organization for the sole use by yourself, employees and agents. You agree to take all necessary steps to insure that your employees and agents abide by the terms of this agreement. Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CPT for resale and/or license, transferring copies of CPT to any party not bound by this agreement, creating any modified or derivative work of CPT, or making any commercial use of CPT. You should contact CPT Intellectual Property Services, American Medical Association, 515 N. State Street, Chicago, Illinois or at telephone number or at facsimile number , should you wish to make additional uses of CPT. Applicable FARS/DFARS Restrictions Apply to Government Use. U.S. Government rights to use, modify, reproduce, release, perform, display, or disclose these technical data and/or computer data bases and/or computer software and/or computer software documentation are subject to the limited rights restrictions of DFARS (b)(2)(June 1995) and/or subject to the restrictions of DFARS (a)(June 1995) and DFARS (a)(June 1995), as applicable for U.S. Department of Defense procurements and the limited rights restrictions of FAR (June 1987) and/or subject to the restricted rights provisions of FAR (June 1987) and FAR (June 1987), as applicable, and any applicable agency FAR Supplements, for non-department of Defense Federal procurements. Disclaimer of Warranties and Liabilities CPT is provided "as is" without warranty of any kind, either expressed of implied, including but not limited to, the implied warranties of merchantability and fitness for a particular purpose. No fee schedules, basic unit, relative values or related listings are included in CPT. The American Medical Association (AMA) does not directly or indirectly practice medicine or dispense medical services. The responsibility for the content of this file/product is the Health Care Financing Administration and no endorsement by the AMA is intended or implied. The AMA disclaims responsibility for any consequences or liability attributable to or related to any use, non-use, or interpretation of information contained or not contained in this file/product. This Agreement will terminate upon notice if you violate its terms. The AMA is a third party beneficiary to this Agreement. CHA/P Codes Pg 1 of 6 Last Modified: 12/20/2012
2 CHA/P CPT and HCPCS Codes CODE Drainage of skin abscess Drainage of skin abscess Remove foreign body Puncture drainage of lesion Exc tr-ext b9+marg 0.5 < cm Exc tr-ext b9+marg cm Exc tr-ext b9+marg cm Exc tr-ext b9+marg cm Exc tr-ext b9+marg cm Exc tr-ext b9+marg > 4.0 cm Exc h-f-nk-sp b9+marg 0.5 < Exc h-f-nk-sp b9+marg Exc h-f-nk-sp b9+marg Exc h-f-nk-sp b9+marg Exc h-f-nk-sp b9+marg Exc h-f-nk-sp b9+marg > 4 cm Exc face-mm b9+marg 0.5 < cm Exc face-mm b9+marg cm Exc face-mm b9+marg cm Exc face-mm b9+marg cm Exc face-mm b9+marg cm Exc face-mm b9+marg > 4 cm Debride nail Debride nail 6 or more Excision of nail fold toe Repair superficial wound(s) Repair superficial wound(s) Initial treatment of burn(s) Dress/debrid p-thick burn s Dress/debrid p-thick burn m Dress/debrid p-thick burn l Treatment of nose fracture Treat lower jaw fracture Treatment of rib fracture Treat clavicle fracture Treat humerus fracture Treat shoulder dislocation Treat humerus fracture Treat fracture of radius CHA/P Codes Pg 2 of 6 Last Modified: 12/20/2012
3 26600 Treat metacarpal fracture Treat pelvic ring fracture Treatment of thigh fracture Treatment of thigh fracture Treatment of thigh fracture Treatment of tibia fracture Treatment of heel fracture Apply long arm splint Apply forearm splint Application of finger splint Strapping of chest Strapping of shoulder Strapping of elbow or wrist Strapping of hand or finger Application long leg splint Application lower leg splint Strapping of toes Remove nasal foreign body Control of nosebleed Control of nosebleed Control of nosebleed Repeat control of nosebleed Routine venipuncture Insert needle bone cavity Insert bladder catheter Insert temp bladder cath Obstetrical care Deliver placenta Maternity care procedure Remove foreign body from eye Remove foreign body from eye Clear outer ear canal Remove impacted ear wax Urinalysis nonauto w/scope Urinalysis auto w/scope Urine pregnancy test Glucose blood test H pylori (c-13) breath H pylori drug admin Hemoglobin copper sulfate 83036* Glycosylated hemoglobin test CHA/P Codes Pg 3 of 6 Last Modified: 12/20/2012
4 85018* Hemoglobin 85610* Prothrombin time TB intradermal test Culture screen only 87210* Smear wet mount saline/ink Chylmd trach ag eia 87804* Influenza assay w/optic 87880* Strep a assay w/optic Hep b ig im Imadm any route 1st vac/tox Inadm any route addl vac/tox Immune admin H1N1 im/nasal Immunization admin Immune admin oral/nasal Hep a vaccine adult im Hep a/hep b vacc adult im Hpv vaccine 4 valent im Hpv vaccine 2 valent im Flu vaccine no preserv 6-35m Flu vaccine no preserv 3 & > Flu vaccine 3 yrs im Flu vaccine 3 yrs & > im Flu vaccine nasal Rotovirus vacc 3 dose oral Mmr vaccine sc Tdap vaccine >7 im Chicken pox vaccine sc Pneumococcal vaccine Zoster vacc sc Hep b vaccine adult im Hep b/hib vaccine im Pure tone hearing test air Pure tone audiometry air Tympanometry Heart/lung resuscitation cpr Airway inhalation treatment Measure blood oxygen level Measure blood oxygen level Hydration iv infusion init Ther/proph/diag iv inf init Ther/proph/diag inj sc/im CHA/P Codes Pg 4 of 6 Last Modified: 12/20/2012
5 96374 Ther/proph/diag inj iv push Medical services after hrs Visual acuity screen Office/outpatient visit new Office/outpatient visit new Office/outpatient visit new Office/outpatient visit new Office/outpatient visit new Office/outpatient visit est Office/outpatient visit est Office/outpatient visit est Office/outpatient visit est Office/outpatient visit est Home visit new patient Home visit new patient Home visit new patient Home visit est patient Home visit est patient Home visit est patient Init pm e/m new pat inf Init pm e/m new pat 1-4 yrs Init pm e/m new pat 1-4 yrs Init pm e/m new pat 1-4 yrs Prev visit new age Per pm reeval est pat inf Prev visit est age Prev visit est age Prev visit est age Prev visit est age Behav chng smoking 3-10 min Behav chng smoking > 10 min Audit/dast min Audit/dast over 30 min Init nb em per day non-fac Nb resuscitation Immunization admin each add Immune admin oral/nasal addl Hydrate iv infusion add-on Ther/proph/diag iv inf addon Tx/pro/dx inj new drug addon A4267 Contraceptive prophylactic condom, male CHA/P Codes Pg 5 of 6 Last Modified: 12/20/2012
6 A4565 A4570 A4580 Sling Splint Cast supplies, (eg, plaster) A4614 A4635 E0100 E0114 J0561 J0696 J0885 J1055 J1438 J1885 J2550 J3420 J7030 J7120 J7613 Peak expiratory flow rate meter, hand held Underarm pad, crutch, replacement, each Cane, includes canes of all materials, adjustable or fixed, with tip Crutches, underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips Injection, penicillin G benzathine, 100,000 units (Bicillin L-A, Permapen) Injection, ceftriaxone sodium, per 250 mg (Brand name: Rocephin) Injection, epoetin alfa, 1000 units (Brand name: Epogen or Procrit Injection, medroxyprogesterone acetate for contraceptive use, 150 mg (Depo-Provera) Injection, etanercept, 25 mg (Brand name: Enbrel) Injection, ketorolac tromethamine, per 15 mg (Brand name: Toradol) Injection, promethazine HCI, up to 50 mg (Brand name: Phenergan) Injection, vitamin B-12 cyanocobalamin, up to 1,000 mcg (Sytobex, Redisol, Rubramin PC, Betalin 12, Berubigen, Cobex, Cobal, Crystal B12, Cyano, Cyano Cobalamin, Hydroxocobalamin, Hydroxocobal, Nutri-Twelve) Infusion, normal saline solution, 1,000 cc Ringer's lactate infusion, up to 1,000 cc Albuterol, inhalation solution, FDA-approved final product, non-compounded product, administered through DME, unit dose, 1 mg L0120 L0140 L4350 L4360 L4370 Cervical, flexible, nonadjustable (foam collar) Cervical, semi-rigid, adjustable (plastic collar) Ankle control orthosis, stirrup style, rigid, includes any type interface material, prefabricated, includes any type interface (eg, pneumatic, gel), prefabricated, includes fitting and adjustment Walking boot, pneumatic, with or without joints, with or without interface material, prefabricated includes fitting and adjustment Pneumatic full leg splint (e.g., air cast), prefabricated, includes fitting and adjustment The CPT code descriptions herein have been shortened to 28 characters or less to comply with copyright restrictions. Please refer to the current CPT for complete descriptions. CHA/P Codes Pg 6 of 6 Last Modified: 12/20/2012
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