Procedure Codes Eligible for 90% FFP When Coded in Combination With a Dx Code in the V25 Range
(see below) *
- Billing Guidance is also available in Excel Format (XLS, 52KB)
Code | Short Description |
---|---|
11975 | Insert contraceptive cap |
11976 | Removal of contraceptive cap |
11977 | Removal/reinsert contra cap |
55250 | Removal of sperm duct(s) |
55450 | Ligation of sperm duct |
58100 | Biopsy of uterus lining |
58300 | Insert intrauterine device |
58301 | Remove intrauterine device |
58340 | Catheter for hysterography |
58565 | Hysteroscopy sterilization |
58600 | Division of fallopian tube |
58615 | Occlude fallopian tube(s) |
58670 | Laparoscopy tubal cautery |
58671 | Laparoscopy tubal block |
71010 | Chest x-ray |
71015 | Chest x-ray |
71020 | Chest x-ray |
74000 | X-ray exam of abdomen |
76830 | Transvaginal us non-ob |
76856 | Us exam pelvic complete |
76857 | Us exam pelvic limited |
77078 | Ct bone density axial |
77079 | Ct bone density peripheral |
77080 | Dxa bone density axial |
77081 | Dxa bone density/peripheral |
77083 | Radiographic absorptiometry |
80048 | Metabolic panel total ca |
80053 | Comprehen metabolic panel |
80061 | Lipid panel |
80076 | Hepatic function panel |
81000 | Urinalysis nonauto w/scope |
81001 | Urinalysis auto w/scope |
81002 | Urinalysis nonauto w/o scope |
81003 | Urinalysis auto w/o scope |
81007 | Urine screen for bacteria |
81015 | Microscopic exam of urine |
81025 | Urine pregnancy test |
82040 | Assay of serum albumin |
82043 | Microalbumin quantitative |
82150 | Assay of amylase |
82247 | Bilirubin total |
82270 | Occult blood feces |
82465 | Assay bld/serum cholesterol |
82550 | Assay of ck (cpk) |
82553 | Creatine mb fraction |
82565 | Assay of creatinine |
82570 | Assay of urine creatinine |
82575 | Creatinine clearance test |
82670 | Assay of estradiol |
82677 | Assay of estriol |
82947 | Assay glucose blood quant |
82948 | Reagent strip/blood glucose |
82950 | Glucose test |
82951 | Glucose tolerance test (GTT) |
83001 | Gonadotropin (FSH) |
83002 | Gonadotropin (LH) |
83690 | Assay of lipase |
84075 | Assay alkaline phosphatase |
84144 | Assay of progesterone |
84146 | Assay of prolactin |
84443 | Assay thyroid stim hormone |
84703 | Chorionic gonadotropin assay |
85002 | Bleeding time test |
85004 | Automated diff wbc count |
85007 | Bl smear w/diff wbc count |
85013 | Spun microhematocrit |
85014 | Hematocrit |
85018 | Hemoglobin |
85025 | Complete cbc w/auto diff wbc |
85027 | Complete cbc automated |
85032 | Manual cell count each |
85045 | Automated reticulocyte count |
85049 | Automated platelet count |
85210 | Blood clot factor II test |
85300 | Antithrombin III test |
85378 | Fibrin degrade semiquant |
85576 | Blood platelet aggregation |
85610 | Prothrombin time |
85651 | Rbc sed rate nonautomated |
85652 | Rbc sed rate automated |
85730 | Thromboplastin time partial |
86580 | TB intradermal test |
86592 | Syphilis test non-trep qual |
86593 | Syphilis test non-trep quant |
86631 | Chlamydia antibody |
86632 | Chlamydia igm antibody |
86687 | Htlv-i antibody |
86689 | HTLV/HIV confirmatory test |
86696 | Herpes simplex type 2 |
86701 | HIV-1 |
86702 | HIV-2 |
86703 | Hiv-1/hiv-2 single assay |
86762 | Rubella antibody |
86900 | Blood typing abo |
86901 | Blood typing rh (d) |
87015 | Specimen concentration |
87040 | Blood culture for bacteria |
87070 | Culture bacteria other |
87075 | Cultr bacteria except blood |
87077 | Culture aerobic identify |
87081 | Culture screen only |
87086 | Urine culture/colony count |
87088 | Urine bacteria culture |
87102 | Fungus isolation culture |
87110 | Chlamydia culture |
87164 | Dark field examination |
87166 | Dark field examination |
87205 | Smear gram stain |
87206 | Smear fluorescent/acid stai |
87207 | Smear special stain |
87210 | Smear wet mount saline/ink |
87252 | Virus inoculation tissue |
87254 | Virus inoculation shell via |
87255 | Genet virus isolate hsv |
87270 | Chlamydia trachomatis ag if |
87273 | Herpes simplex 2 ag if |
87274 | Herpes simplex 1 ag if |
87320 | Chylmd trach ag eia |
87390 | Hiv-1 ag eia |
87486 | Chylmd pneum dna amp probe |
87490 | Chylmd trach dna dir probe |
87491 | Chylmd trach dna amp probe |
87495 | Cytomeg dna dir probe |
87535 | Hiv-1 dna amp probe |
87590 | N.gonorrhoeae dna dir prob |
87591 | N.gonorrhoeae dna amp prob |
87620 | Hpv dna dir probe |
87621 | Hpv dna amp probe |
87797 | Detect agent nos dna dir |
87800 | Detect agnt mult dna direc |
87801 | Detect agnt mult dna ampli |
87899 | Agent nos assay w/optic |
88141 | Cytopath c/v interpret |
88142 | Cytopath c/v thin layer |
88143 | Cytopath c/v thin layer redo |
88147 | Cytopath c/v automated |
88148 | Cytopath c/v auto rescreen |
88150 | Cytopath c/v manual |
88152 | Cytopath c/v auto redo |
88153 | Cytopath c/v redo |
88154 | Cytopath c/v select |
88155 | Cytopath c/v index add-on |
88160 | Cytopath smear other source |
88161 | Cytopath smear other source |
88162 | Cytopath smear other source |
88164 | Cytopath tbs c/v manual |
88165 | Cytopath tbs c/v redo |
88173 | Cytopath eval fna report |
88174 | Cytopath c/v auto in fluid |
88175 | Cytopath c/v auto fluid redo |
88302 | Tissue exam by pathologist |
88305 | Tissue exam by pathologist |
88307 | Tissue exam by pathologist |
89321 | Semen anal sperm detection |
93000 | Electrocardiogram complete |
93010 | Electrocardiogram report |
93040 | Rhythm ECG with report |
93307 | Tte w/o doppler complete |
99050 | Medical services after hrs |
99051 | Med serv eve/wkend/holiday |
99070 | Special supplies |
99201 | Office/outpatient visit new |
99202 | Office/outpatient visit new |
99203 | Office/outpatient visit new |
99204 | Office/outpatient visit new |
99205 | Office/outpatient visit new |
99211 | Office/outpatient visit est |
99212 | Office/outpatient visit est |
99213 | Office/outpatient visit est |
99214 | Office/outpatient visit est |
99215 | Office/outpatient visit est |
99241 | Office consultation |
99242 | Office consultation |
99243 | Office consultation |
99244 | Office consultation |
99245 | Office consultation |
99384 | Prev visit new age 12-17 |
99385 | Prev visit new age 18-39 |
99386 | Prev visit new age 40-64 |
99394 | Prev visit est age 12-17 |
99395 | Prev visit est age 18-39 |
99396 | Prev visit est age 40-64 |
∗ | This list is a subset of Family Planning procedures and only includes |
A4266 | Diaphragm |
A4267 | Male condom |
A4268 | Female condom |
A4931 | Reusable oral thermometer |
J1055 | Medrxyprogester acetate inj |
J1056 | MA/EC contraceptiveinjection |
J7300 | Intraut copper contraceptive |
J7302 | Levonorgestrel iu contracept |
J7303 | Contraceptive vaginal ring |
J7304 | Contraceptive hormone patch |
J7306 | Levonorgestrel implant sys |
J7307 | Etonogestrel implant system services that are eligible for 90% Federal financial participation |
V25 Diagnosis - Potentially Eligible for Enhanced Medicaid Payment | |
---|---|
DX general format |
Description |
V2501 | Prescrip-oral contracept |
V2502 | Initiate contracept NEC |
V2503 | Contracept mgmt-emergncy |
V2504 | Natrl fam pln-avoid preg |
V2509 | Contraceptive mangmt NEC |
V2511 | Insertion of iud |
V2512 | Removal of iud |
V2513 | Remove/insert iud |
V252 | Sterilization |
V252 | Sterilization |
V253 | Menstrual extraction |
V2540 | Contracept surveill NOS |
V2541 | Contracept pill surveill |
V2542 | Iud surveillance |
V2543 | Srvl mplnt sbdrm cntrcep |
V2549 | Contracept surveill NEC |
V255 | Nsrt mplnt sbdrm cntrcep |
V258 | Contraceptive mangmt NEC |
V259 | Contraceptive mangmt NOS |