Codes from CPSI Code Listing that Support Medical Necessity **Choose a corresponding ICD9 code from the corresponding group that the CPT code resides in when selecting a code that supports Medical Necessity. CPT 84702 - CHORIONIC GONADOTROPIN TEST Resolution Code 1: ICD-9 Codes Covered by Medicare 1580 - MAL NEO RETROPERITONEUM 1588 - MAL NEO PERITONEUM NEC 1642 - MAL NEO ANT MEDIASTINUM 1643 - MAL NEO POST MEDIASTINUM 1648 - MAL NEO MEDIASTINUM NEC 1649 - MAL NEO MEDIASTINUM NOS 181 - MALIGNANT NEOPL PLACENTA 1830 - MALIGN NEOPL OVARY 1838 - MAL NEO ADNEXA NEC 1860 - MAL NEO UNDESCEND TESTIS 1869 - MALIG NEO TESTIS NEC 1944 - MALIGN NEO PINEAL GLAND 1971 - SEC MAL NEO MEDIASTINUM 1976 - SEC MAL NEO PERITONEUM 1986 - SECOND MALIG NEO OVARY 19882 - SECOND MALIG NEO GENITAL 2361 - UNC BEHAV NEO PLACENTA 3383 - NEOPLASM RELATED PAIN ACUTE CHRON 6238 - NONINFLAM DIS VAGINA NEC 6259 - FEM GENITAL SYMPTOMS NOS 630 - HYDATIDIFORM MOLE 631 - OTH ABN PROD CONCEPTION 632 - MISSED ABORTION 63390-63391 - See Diagnosis Table Display for Description 63400-63402 - See Diagnosis Table Display for Description 64000-64003 - See Diagnosis Table Display for Description 64230-64234 - See Diagnosis Table Display for Description 1
Resolution Code 1: ICD-9 Codes Covered by Medicare 64240-64274 - See Diagnosis Table Display for Description 64290-64294 - See Diagnosis Table Display for Description 79589 - OTHER ABNORMAL TUMOR MARKERS V1009 - HX OF GI MALIGNANCY NEC V1029 - HX-INTRATHORACIC MAL NEC V1043 - HX OF OVARIAN MALIGNANCY V1047 - HX-TESTICULAR MALIGNANCY V220-V221 - See Diagnosis Table Display for Description 7980-7989 - See Diagnosis Table Display for Description V1585 - PER HIST CONT-EXP POT HAZ BDY FLUID V161 - FM HX-TRACH BRONCHOG MAL V162 - FAM HX-INTRATHORACIC MAL V1640 - FAM HIST OF MALIG NEOPLASM GENITAL V1650 - Description Not Found V1651 - FAM HIS - MAL NEO - KIDNEY V1652 - FAMILY HISTORY OF MALIGNANT NEOPLAS V1659 - FAM HIS - AL NEO - OTH URIN ORG V166 - FAMILY HX-LEUKEMIA V167 - FAM HX-LYMPH NEOPLAS NEC V168 - FAMILY HX-MALIGNANCY NEC V169 - FAMILY HX-MALIGNANCY NOS V170-V1789 - See Diagnosis Table Display for Description V1741 - FAMILY HISTORY OF SUDDEN CARDIAC DE V1749 - FAMILY HISTORY OF OTHER CARDIOVASCU V180 - FAM HX-DIABETES MELLITUS V1811 - FAMILY HISTORY OF MULTIPLE ENDOCRIN V1819 - FAMILY HISTORY OF OTHER ENDOCRINE A V182 - FAMILY HX-ANEMIA V183 - FAM HX-BLOOD DISORD NEC V184 - FAM HX-MENTAL RETARDAT V1851 - FAMILY HISTORY, COLONIC POLYPS 2
V1859 - FAMILY HISTORY OTHER DIGESTIVE DISO V1861 - FAM HIS - POLY KIDNEY V1869 - FAM HIS - OTH KIDNEY DISEASES V187 - FAMILY HX-GU DISEASE NEC V188 - FM HX-INFECT PARASIT DIS V189 - FAMILY HX OF GENETIC DISEASE CARRIE V190 - FAMILY HX-BLINDNESS V191 - FAMILY HX-EYE DISORD NEC V192 - FAMILY HX-DEAFNESS V193 - FAMILY HX-EAR DISORD NEC V194 - FAMILY HX-SKIN CONDITION V195 - FAM HX-CONGEN ANOMALIES V196 - FAMILY HX-ALLERGIC DIS V197 - CONSANGUINITY V198 - FAMILY HX-CONDITION NEC V200 - FOUNDLING HEALTH CARE V201 - CARE OF HEALTHY CHLD NEC V202 - ROUTIN CHILD HEALTH EXAM V2031-V2032 - See Diagnosis Table Display for Description V280 - SCREENING-CHROMOSOM ANOM V281 - SCREEN-ALPHAFETOPROTEIN V282 - SCREEN BY AMNIOCENT NEC V283 - ENCOUNTER FOR ROUTINE SCREENING MAL V284 - SCREEN-FETAL RETARDATION V285 - SCREEN-ISOIMMUNIZATION V286 - ANTENATAL SCREEN FOR STREPTCOCCUS B V287 - Description Not Found V288 - ANTENATAL SCREENING NEC V289 - ANTENATAL SCREENING NOS V500-V509 - See Diagnosis Table Display for Description V532 - ADJUSTMENT HEARING AID V600 - LACK OF HOUSING V601 - INADEQUATE HOUSING 3
V602 - ECONOMIC PROBLEM V603 - PERSON LIVING ALONE V604 - NO FAMILY ABLE TO CARE V605 - HOLIDAY RELIEF CARE V606 - PERSON IN RESIDENT INST V6081 - FOSTER CARE STATUS V6089 - HOUSING-ECONO CIRCUM NEC V609 - HOUSING ECONO CIRCUM NOS V620 - UNEMPLOYMENT V621 - ADVERSE EFF-WORK ENVIRON V650 - HEALTHY PERSON W SICK V6511 - PED PREBIRTH VISIT EXPECT PARENTS V6519 - OTHER PERSON CONSULT ON BEHALF OTHE V680-V689 - See Diagnosis Table Display for Description V700 - ROUTINE MEDICAL EXAM V701 - PSYCH EXAM-AUTHORITY REQ V702 - GEN PSYCHIATRIC EXAM NEC V703 - MED EXAM NEC-ADMIN PURP V704 - EXAM-MEDICOLEGAL REASONS V705 - HEALTH EXAM-GROUP SURVEY V706 - HEALTH EXAM-POP SURVEY V707 - EXAM OF PARTICIPANT IN CLNL TRIAL V708 - GENERAL MEDICAL EXAM NEC V709 - GENERAL MEDICAL EXAM NOS V730 - SCREENING-POLIOMYELITIS V731 - SCREENING FOR SMALLPOX V732 - SCREENING FOR MEASLES V733 - SCREENING FOR RUBELLA V734 - SCREENING-YELLOW FEVER V735 - SCREENING-ARBOVIRUS DIS V736 - SCREENING FOR TRACHOMA V7381 - SPECIAL SCREENING EXAM, HPV V7388-V7389 - See Diagnosis Table Display for Description 4
V7398-V7399 - See Diagnosis Table Display for Description V740 - SCREENING FOR CHOLERA V741 - SCREENING-PULMONARY TB V742 - SCREENING FOR LEPROSY V743 - SCREENING FOR DIPHTHERIA V744 - SCREEN-BACT CONJUNCTIVIT V745 - SCREEN FOR VENERAL DIS V746 - SCREENING FOR YAWS V747 - Description Not Found V748 - SCREEN-BACTERIAL DIS NEC V749 - SCREEN-BACTERIAL DIS NOS V750 - SCREEN-RICKETTSIAL DIS V751 - SCREENING FOR MALARIA V752 - SCREEN FOR LEISHMANIASIS V753 - SCREEN-TRYPANOSOMIASIS V754 - SCREEN-MYCOTIC INFECT V755 - SCREEN-SCHISTOSOMIASIS V756 - SCREEN FOR FILARIASIS V757 - SCREEN FOR HELMINTHIASIS V758 - SCREEN-PARASITIC DIS NEC V759 - SCREEN FOR INFEC DIS NOS V760 - SCREEN MAL NEOP-RESP ORG V763 - SCREEN MAL NEOP-BLADDER V7642-V7643 - See Diagnosis Table Display for Description V7645-V7647 - See Diagnosis Table Display for Description V7649 - SPEC SCREEN FOR MALIG OTHER SITES V7650 - SPEC SCREEN FOR MALIG NEOP INTESTIN V7652 - SPEC SCREEN FOR MALIG NEOP SM INTES V7681 - SPEC SCREEN FOR MALIG NEOP NERV SYS V7689 - SPEC SCREEN FOR OTHER MALIG NEOPLAS V769 - SCREEN-NEOPLASM NOS V770 - SCREEN-THYROID DISORDER V772-V7799 - See Diagnosis Table Display for Description 5
V780-V7899 - See Diagnosis Table Display for Description V790-V7999 - See Diagnosis Table Display for Description V8001 - SCREEN-TRAUMATIC BRAIN INJURY V8009 - SCREEN-NEURO CONDITION V801 - SCREENING FOR GLAUCOMA V802 - SCREENING-EYE COND NEC V803 - SCREENING FOR EAR DIS V813 - SCREEN-BRONCH EMPHYSEMA V814 - SCREEN-RESPIR COND NEC V815 - SCREEN FOR NEPHROPATHY V816 - SCREEN FOR GU COND NEC V820 - SCREEN FOR SKIN COND V821 - SCREEN-RHEUMATOID ARTHR V822 - SCREEN-RHEUMAT DIS NEC V823 - SCREEN-CONG HIP DISLOCAT V824 - MAT POSTNATAL SCRN CHROMO ANOMAL V825 - SCREEN-CONTAMINATION NEC V826 - MULTIPHASIC SCREENING V8271 - SCREENING OF GENETIC DISEASE STATUS V8279 - OTHER GENETIC SCREENING V8281 - SPECIAL SCREENING FOR OSTEOPOROSIS V8289 - SPECIAL SCREEN OTHER SPECIFIED COND V829 - SCREEN FOR CONDITION NOS 6