Appendix F – ICD Codes for Measures #1 and #2

Error Prevention Measurement Methodology, Appendix F & G January 1 to June 30, 2008 Version 9.0a Updated for ICD-9 CM and CPT Code Changes Effective January 1, 2008

Questions or comments can be directed to Bob Beaverson at 608-274-1820 or [email protected].

Appendix F – ICD Codes for Measures #1 and #2

ICD Code 0070 0071 0072 0073 0080 0081 0082 0083 0084 0085 0086 0087 0111 0112 0113 0114 0115 0118 0121 0122 0123 0124 0125 0128 0131 0132 0139 0141 0142 0151 0152 0153 0159 016 0201 0202 0203 0204 0205 0206 0207

Code Description REV HIP REPLACEMENT, BOTH ACETABULA REV HIP REPLACEMENT, ACETABULAR COM REV HIP REPLACEMENT, FEMORAL COMPON REV HIP REPLACEMENT REV KNEE REPLACEMENT, TOTAL REV KNEE REPLACEMENT, TIBIAL REV KNEE REPLACEMENT, FEMORAL REV KNEE REPLACEMENT, PATELLAR REV TOTAL KNEE REPLACEMENT, TIBIAL HIP RESURFACING-TOTAL HIP RESURFACING-FEM HEAD HIP RESURFACING-ACETAB CLO PERCUT NEEDLE BX CEREB MENINGE OP BX CEREBRAL MENINGES CLO [PERCUT] [NEEDLE] BX BRAIN OP BX BRAIN BX SKULL OTH DX PROC BRAIN-CEREB MENINGES I&D CRANIAL SINUS REMOVAL INTRACRAN NEUROSTIM LEAD(S) REOPEN CRANIOTOMY SITE OTH CRANIOTOMY OTH CRANIEC PLACE IC CATH-BURR HOLE INCIS CEREBRAL MENINGES LOBOTOMY & TRACTOTOMY OTH INCIS BRAIN OPER THALAMUS OPER GLOBUS PALLIDUS EXC LES/TISS CEREBRAL MENINGES HEMISPHERECTOMY LOBEC BRAIN OTH EXC/DESTRUC LES/TISS BRAIN EXC LES SKULL OPENING CRANIAL SUT ELEV SKULL FX FRAGMENTS FORMATION CRANIAL BONE FLAP BONE GFT SKULL INSRT SKULL PLATE OTH CRANIAL OSTEOPLASTY REMOV SKULL PLATE

A 06

OCT 06 OCT 06 OCT 06

1-Oct-06

D 06

A 07

D 07

Appendix F – ICD Codes for Measures #1 and #2

ICD Code 0212 0213 0214 022 0231 0232 0233 0234 0235 0239 0241 0242 0243 0291 0292 0293 0301 0309 031 0321 0329 036 0371 0372 0379 038 0401 0402 0403 0404 0405 0406 0407 0411 0412 0419 042 0441 0442 0443 0444

Code Description OTH REPR CEREBRAL MENINGES LIG MENINGEAL VESSEL CHOROID PLEXECTOMY VENTRICULOSTOMY VENT SHUNT HEAD & NECK STRUCT VENT SHUNT-CIRC SYST VENT SHUNT-THOR CAVITY VENT SHUNT-ABD CAVITY & ORGANS VENT SHUNT-URIN SYST OTH OPER ESTAB VENT DRAIN IRRIGATION&EXPL VENTRICULAR SHUNT REPLCMT VENT SHUNT REMOV VENT SHUNT LYSIS CORTICAL ADHES REPR BRAIN IMPL/REPL INTRACRAN NEUROSTIM LEAD REMOV FB SPINAL CANAL OTH EXPLOR & DECOMP SPINAL CANAL DIVIS INTRASPINAL NERV ROOT PERCUT CHORDOTOMY OTH CHORDOTOMY LYSIS ADHES SPINAL CORD-NERV ROOTS SPINAL SUBARACHNOID-PERITON SHUNT SPINAL SUBARACHNOID-URETERAL SHUNT OTH SHUNT SPINAL THECA INJ DESTRUCT AGENT SPINAL CANAL EXC ACOUSTIC NEUROMA DIVIS TRIGEMINAL NERV DIVIS/CRUSH OTH CRANIAL-PERIPH NERV OTH INCIS CRANIAL & PERIPH NERV GASSERIAN GANGLIONECTOMY OTH CRANIAL/PERIPH GANGLIONECTOMY OTH EXC/AVUL CRANIAL & PERIPH NERV CLO BX CRANIAL/PERIPH NERV/GANGL OP BX CRANIAL/PERIPH NERV/GANGL OTH DX CRANIAL-PERIPH NERV-GANGL DESTRUC CRANIAL & PERIPH NERV DECOMP TRIGEMINAL NERV ROOT OTH CRANIAL NERV DECOMP RELEASE CARPAL TUNNEL RELEASE TARSAL TUNNEL

A 06

D 06

A 07

D 07

Appendix F – ICD Codes for Measures #1 and #2

ICD Code 0449 045 046 0471 0472 0473 0474 0475 0476 0479 0480 0481 0489 0491 050 0511 0519 0521 0522 0523 0524 0525 0529 0531 0532 0539 0589 059 0801 0802 0809 0811 0819 0820 0821 0822 0823 0824 0825 0831 0832

Code Description OTH PERIPH NERV/GANGL DECOMP/LYSIS CRANIAL/PERIPH NERV GFT TRANSPOSITION CRANIAL & PERIPH NERV HYPOGLOSSAL-FACIAL NERV ANASTOM ACCESS-FACIAL NERV ANASTOM ACCESS-HYPOGLOSSAL NERV ANASTOM OTH ANASTOM CRANIAL/PERIPH NERV REVIS PREV REPR CRANIAL-PERIPH NERV REPR OLD TRAUMA CRANIAL-PERIPH NERV OTH NEUROPLASTY PERIPH NERV INJ-NOS INJ ANES PERIPH NERV-ANALGESIA INJ NON-NEUROLYTIC PERIPH NERV NEURECTASIS DIVIS SYMPATHETIC NERV/GANGL BX SYMPATHETIC NERV/GANGL OTH DX PROC SYMPATH NERV/GANGL SPHENOPALATINE GANGLIONECTOMY CERV SYMPATHECTOMY LUMB SYMPATHECTOMY PRESACRAL SYMPATHECTOMY PERIARTERIAL SYMPATHECTOMY OTH SYMPATHECTOMY-GANGLIONECT INJ ANES SYMPATHETIC NERV-ANALGES INJ NEUROLYTIC SYMPATHETIC NERV OTH INJ SYMPATHETIC NERV/GANGL OTH OPER SYMPATHETIC NERV/GANGL OTH OPER NERV SYST INCIS LID MARGIN SEVER BLEPHARORRHAPHY OTH EYELID INCIS BX EYELID OTH DX PROC EYELID REMOV LES EYELID-NOS EXC CHALAZION EXC OTH MINOR LES EYELID EXC MAJOR LES EYELID-PART THICK EXC MAJOR LES EYELID-FULL-THICK DESTRUC LES EYELID REPR BLEPHAROPT-FRONTALIS MUSC-SUT REPR BLEPHAROPT-FRONTALIS MUS-SLING

A 06

D 06

A 07

D 07

Appendix F – ICD Codes for Measures #1 and #2

ICD Code 0833 0834 0835 0836 0837 0838 0841 0842 0843 0844 0849 0851 0852 0859 0861 0862 0863 0864 0869 0870 0871 0872 0873 0874 0882 0883 0884 0885 0886 0887 0889 0891 0892 0893 0899 0911 0912 0919 0920 0921 0922

Code Description REPR BLEPHAROPT-RESECT/ADVANC LEVAT REPR BLEPHAROPT-OTH LEVATOR MUSC REPR BLEPHAROPTOSIS-TARSAL TECH REPR BLEPHAROPTOSIS-OTH TECH REDUC OVERCORRECT PTOSIS CORRECT LID RETRACT REPR ENTROPION/ECTROP-THERMOCAUT REPR ENTROPION/ECTROPION-SUT TECH REPR ENTROPION/ECTROP-WEDGE RESECT REPR ENTROPION/ECTROP-LID RECON OTH REPR ENTROPION/ECTROPION CANTHOTOMY BLEPHARORRHAPHY OTH ADJUSTMENT LID POSIT RECON EYELID W/SKIN FLAP/GFT RECON LID-MUCOUS MEMBRN FLAP/GFT RECON EYELID W/HAIR FOLLICLE GFT RECON LID-TARSOCONJUNCTIVAL FLAP OTH RECON EYELID W/FLAPS/GFT RECON EYELID-NOS RECON LID INVOLV MARGIN-PART-THICK OTH RECON EYELID-PART-THICK RECON LID INVOLV MARGIN-FULL-THICK OTH RECON EYELID-FULL-THICK REPR LAC EYELID MARGIN-PART-THICK OTH REPR LAC EYELID-PART-THICK REPR LAC EYELID MARGIN-FULL-THICK OTH REPR LAC EYELID-FULL-THICK LOWER EYELID RHYTIDECTOMY UPPER EYELID RHYTIDECTOMY OTH EYELID REPR ELEC-SURG EPILATION EYELID CRYOSURG EPILATION EYELID OTH EYELID EPILATION OTH OPER EYELIDS BX LACRML GLAND BX LACRML SAC OTH DX PROC LACRML SYST EXC LACRML GLAND-NOS EXC LES LACRML GLAND OTH PART DACRYOADENECTOMY

A 06

D 06

A 07

D 07

Appendix F – ICD Codes for Measures #1 and #2

ICD Code 0923 093 0941 0942 0944 0949 0951 0952 0953 0959 096 0971 0972 0973 0981 0982 0983 0991 0999 100 101 1021 1029 1031 1032 1033 1041 1042 1043 1044 1049 105 1091 1099 110 111 1121 1122 1129 1131 1132

Code Description TOT DACRYOADENECTOMY OTH OPER LACRML GLAND PROBE LACRML PUNCTUM PROBE LACRML CANALICULI INTUBATE NASOLACRML DUCT OTH MANIP LACRML PASSAGE INCIS LACRML PUNCTUM INCIS LACRML CANALICULI INCIS LACRML SAC OTH INCIS LACRML PASSAGES EXC LACRML SAC & PASSAGE CORRECT EVERTED PUNCTUM OTH REPR PUNCTUM REPR CANALICULUS DACRYOCYSTORHINOSTOMY [DCR] CONJUNCTIVOCYSTORHINOSTOMY CONJUNCTIVORHINOSTOMY W/TUBE/STENT OBLIT LACRML PUNCTUM OTH OPER LACRML SYST INCIS W/REMOV EMBEDDED FB-CONJ OTH CONJ INCIS BX CONJ OTH DX PROC CONJ EXC LES/TISS CONJ DESTRUC LES CONJ OTH CONJ DESTRUC PROC REPR SYMBLEPHARON W/FREE GFT RECON CONJ CUL-DE-SAC W/FREE GFT OTH RECON CONJ CUL-DE-SAC OTH FREE GFT CONJ OTH CONJUNCTIVOPLASTY LYSIS CONJ & EYELID ADHES SUBCONJUNCTIVAL INJ OTH OPER CONJ MAGNETIC REMOV EMBEDDED FB CORNEA INCIS CORNEA SCRAPE CORNEA-SMEAR/CULT BX CORNEA OTH DX PROC CORNEA TRANSPOSITION PTERYGIUM EXC PTERYGIUM W/CORNEAL GFT

A 06

D 06

A 07

D 07

Appendix F – ICD Codes for Measures #1 and #2

ICD Code 1139 1141 1142 1143 1149 1159 1160 1161 1162 1163 1164 1169 1172 1173 1174 1175 1176 1179 1191 1192 1199 1200 1201 1202 1211 1212 1213 1214 1221 1222 1229 1231 1232 1233 1234 1235 1239 1240 1241 1242 1243

Code Description OTH EXC PTERYGIUM MECH REMOV CORNEAL EPITHELIUM THERMOCAUTERIZATION CORNEAL LES CRYOTHERAPY CORNEAL LES OTH REMOV/DESTRUC CORNEAL LES OTH CORNEAL REPR CORNEAL TRANSPL-NOS LAMELLAR KERATOPLASTY W/AUTOGFT OTH LAMELLAR KERATOPLASTY PENETRATING KERATOPLASTY W/AUTOGFT OTH PENETRATING KERATOPLASTY OTH CORNEAL TRANSPL KERATOPHAKIA KERATOPROSTHESIS THERMOKERATOPLASTY RADIAL KERATOTOMY EPIKERATOPHAKIA OTH RECON & REFRACTIVE CORNEA SURG TATTOOING CORNEA REMOV ARTIFICIAL IMPLNT CORNEA OTH OPER CORNEA REMOV INTRAOCCU FB ANT SEGMT-NOS REMOV INTRAOCCU FB ANT SEGMT-MAGNET REMOV INTRAOCCU FB ANT SEGMT WO MAG IRIDOTOMY W/TRANSFIXION OTH IRIDOTOMY EXC PROLAPSED IRIS OTH IRIDECTOMY DX ASPIR ANT CHAMBR-EYE BX IRIS OTH IRIS-CILIARY-SCLERA-ANT CHAMBR LYSIS GONIOSYNECHIAE LYSIS OTH ANT SYNECHIAE LYSIS POST SYNECHIAE LYSIS CORNEOVITREAL ADHES COREOPLASTY OTH IRIDOPLASTY REMOV LES ANT SEGMT-EYE-NOS DESTRUC LES IRIS-NONEXCISONAL EXC LES IRIS DESTRUC LES CILIARY BODY-NONEXCIS

A 06

D 06

A 07

D 07

Appendix F – ICD Codes for Measures #1 and #2

ICD Code 1244 1251 1252 1253 1254 1255 1259 1261 1262 1263 1264 1265 1266 1269 1271 1272 1273 1274 1279 1281 1282 1283 1284 1285 1286 1287 1288 1289 1291 1292 1293 1297 1298 1299 1301 1302 1311 1319 132 133 1341

Code Description EXC LES CILIARY BODY GONIOPUNCTURE WO GONIOTOMY GONIOTOMY WO GONIOPUNCTURE GONIOTOMY W/GONIOPUNCTURE TRABECULOTOMY AB EXT CYCLODIALYSIS OTH FACILITATION INTRAOCCULAR CIRC TREPHINATION SCLERA W/IRIDECTOMY THERMOCAUTERIZE SCLERA W/IRIDECTOMY IRIDENCLEISIS & IRIDOTASIS TRABECULECTOMY AB EXT OTH SCLERAL FISTULIZA-IRIDECTOMY POSTOP REVIS SCLERL FISTULIZAT PROC OTH SCLERAL FISTULIZING PROC CYCLODIATHERMY CYCLOCRYOTHERAPY CYCLOPHOTOCOAGULATION DIMINUTION CILIARY BODY-NOS OTH GLAU PROC SUT LAC SCLERA REPR SCLERAL FIST REVIS OPER WOUND ANT SEGMT-NEC EXC/DESTRUC LES SCLERA REPR SCLERAL STAPHYLOMA W/GFT OTH REPR SCLERAL STAPHYLOMA SCLERAL REINFORCEMENT W/GFT OTH SCLERAL REINFORCEMENT OTH OPER SCLERA THERAP EVAC ANT CHAMBR INJ ANT CHAMBR REMOV/DESTRUC EPITHEL-ANT CHAMBR OTH OPER IRIS OTH OPER CILIARY BODY OTH OPER ANT CHAMBR REMOV FB LENS W/MAGNET REMOV FB LENS WO MAGNET INTRACAP LENS EXTRCT-TEMPORAL INFER OTH INTRACAPSUL LENS EXTRACT EXTRACAP LENS EXTRCT-LINEAR EXTRACT EXTRACAP LENS EXTRACT-SIMPL ASPIR PHACOEMULSIFICATION-ASPIR CATARACT

A 06

D 06

A 07

D 07

Appendix F – ICD Codes for Measures #1 and #2

ICD Code 1342 1343 1351 1359 1364 1365 1366 1369 1370 1371 1372 138 1390 1391 1400 1401 1402 1411 1419 1421 1422 1423 1424 1425 1426 1427 1429 1431 1432 1433 1434 1435 1439 1441 1449 1451 1452 1453 1454 1455 1459

Code Description MECH PHACOFRAG-ASPIR CATARACT-POST MECH PHACOFRAG-OTH ASPIR CATARACT EXTRACAP LENS EXTRCT-TEMPORAL INFER OTH EXTRACAPSUL LENS EXTRACT DISCISSION SECNDRY MEMBRN EXC SECNDRY MEMBRN [AFTER CATARACT] MECH FRAGMENT SECNDRY MEMBRN OTH CATARACT EXTRACT INSRT PSEUDOPHAKOS-NOS IOL PROSTH-CATARACT EXTRACT-1-STAGE SECNDRY INSRT IOL PROSTH REMOV LENS IMPLNT OPERATION ON LENS-NEC IMPL INOC TESC PROSTH REMOV FB POST SEGMT-EYE-NOS REMOV FB POST SEGMT-EYE W/MAGNET REMOV FB POST SEGMT-EYE WO MAGNET DX ASPIR VITREOUS OTH RETINA-CHOROID-VIT-POST CHAMBR DEST CHORIORETIN LES-DIATHERMY DEST CHORIORETIN LES-CRYOTHERAPY DEST CHORIORETIN LES-XENON ARC DEST CHORIORETIN LES-LASER PHOTO DEST CHORIORETIN LES-PHOTOCOAG-UNS DEST CHORIORETIN LES-RAD THERAP DEST CHORIORETIN LES-IMPLNT RAD OTH DESTRUC CHORIORETINAL LES REPR RETINAL TEAR-DIATHERMY REPR RETINAL TEAR-CRYOTHERAPY REPR RETINAL TEAR-XENON ARC REPR RETINAL TEAR-LASER PHOTOCOAG REPR RETINAL TEAR-UNS PHOTOCOAG OTH REPR RETINAL TEAR SCLERAL BUCKLING W/IMPLNT OTH SCLERAL BUCKLING REPR RETINAL DETACH-DIATHERMY REPR RETINAL DETACH-CRYOTHERAPY REPR RETINAL DETACH-XENON ARC REPR RETINAL DETACH-LASER REPR RETINAL DETACH-UNS PHOTOCOAG OTH REPR RETINAL DETACH

A 06

OCT 06 OCT 06

D 06

A 07

D 07

Appendix F – ICD Codes for Measures #1 and #2

ICD Code 146 1471 1472 1474 1475 1479 149 1501 1509 1511 1512 1513 1519 1521 1522 1529 153 154 155 156 159 1691 1692 1693 1698 1699 1802 1809 1812 1821 1829 1831 1839 185 186 1871 1879 189 190 1911 1919

Code Description REMOV SURG IMPLNT MAT-POST SEGMT REMOV VITREOUS-ANT APPRCH OTH VITREOUS REMOV OTH MECH VITRECTOMY INJ VITREOUS SUBSTITUTE OTH OPER VITREOUS OTH OPER RETINA-CHOROID-POST CHAMBR BX EXTRAOCCULAR MUSC/TENDON OTH DX PROC EXTRAOCC MUSC-TENDONS RECESSION 1 EXTRAOCCULAR MUSC ADVANCEMENT 1 EXTRAOCCULAR MUSC RESECT 1 EXTRAOCCULAR MUSC OTH 1 EXTRAOCC MUSC-TEMP DETACH LENGTHEN PROC 1 EXTRAOCCULAR MUSC SHORTEN PROC 1 EXTRAOCCULAR MUSC OTH OPER 1 EXTRAOCCULAR MUSC >=2 EXTRAOCC MUSC-TEMP DETCH-1/BOTH >=2 EXTRAOCCULAR MUSC-1/BOTH EYES TRANSPOSITION EXTRAOCCULAR MUSC REVIS EXTRAOCCULAR MUSC SURG OTH OPER EXTRAOCC MUSC-TENDONS RETROBULBAR INJ THERAP AGENT EXC LES ORBIT EXC LES EYE-UNS STRUCT OTH OPER ORBIT OTH OPER EYEBALL INCIS EXT AUDITORY CANAL OTH INCIS EXT EAR BX EXT EAR EXC PREAURICULAR SINUS EXC/DESTRUC OTH LES EXT EAR RAD EXC LES EXT EAR OTH EXC EXT EAR SURG CORRECT PROMINENT EAR RECON EXT AUDITORY CANAL CONSTRUCTION AURICLE EAR OTH PLSTC REPR EXT EAR OTH OPER EXT EAR STAPES MOBILIZATION STAPEDECTOMY W/INCUS REPLCMT OTH STAPEDECTOMY

A 06

D 06

A 07

D 07

Appendix F – ICD Codes for Measures #1 and #2

ICD Code 1921 1929 193 194 1952 1953 1954 1955 196 199 2021 2022 2023 2032 2039 2041 2042 2049 2051 2059 2061 2062 2071 2072 2079 208 2091 2092 2093 2094 2096 2097 2098 2099 301 3021 3022 3029 310 311 313

Code Description REVIS STAPEDECTOMY W/INCUS REPLCMT OTH REVIS STAPEDECTOMY OTH OPER OSSICULAR CHAIN MYRINGOPLASTY TYPE II TYMPANOPLASTY TYPE III TYMPANOPLASTY TYPE IV TYMPANOPLASTY TYPE V TYMPANOPLASTY REVIS TYMPANOPLASTY OTH REPR MID EAR INCIS MASTOID INCIS PETROUS PYRAMID AIR CELLS INCIS MID EAR BX MID & INNER EAR OTH DX PROC MID & INNER EAR SIMPL MASTOIDECTOMY RAD MASTOIDECTOMY OTH MASTOIDECTOMY EXC LES MID EAR OTH EXC MID EAR FENESTRATION INNER EAR (INITIAL) REVIS FENESTRATION INNER EAR ENDOLYMPHATIC SHUNT INJ INNER EAR OTH INCIS-EXC & DESTRUC INNER EAR OPER EUSTACHIAN TUBE TYMPANOSYMPATHECTOMY REVIS MASTOIDECTOMY REPR OVAL & ROUND WINDOWS INJ TYMPANUM IMPLNT/REPLCMT COCH PROSTH-NOS IMPLNT/REPLCMT COCH PROSTH-1 CHNNL IMPLNT/REPLCMT COCH PROSTH-MX CHNNL OTH OPER MID & INNER EAR HEMILARYNGECTOMY EPIGLOTTIDECTOMY VOCAL CORDECTOMY OTH PART LARYNGECTOMY INJ LARYNX TEMP TRACHEOSTOMY OTH INCIS LARYNX/TRACHEA

A 06

D 06

A 07

D 07

Appendix F – ICD Codes for Measures #1 and #2

ICD Code 3141 3143 3144 3145 3148 3149 315 3162 3163 3164 3169 3175 3179 3191 3192 3193 3195 3198 3201 3209 321 3220 3221 3222 3223 3224 3225 3226 3228 3229 3230 3241 3249 3250 3259 323 324 325 326 329 331

Code Description TRACHEOSCOPY THRU ARTIFICIAL STOMA CLO [ENDO] BX LARYNX CLO [ENDO] BX TRACHEA OP BX LARYNX/TRACHEA OTH DX PROC LARYNX OTH DX PROC TRACHEA LOC EXC/DESTRUC LES/TISS TRACHEA CLO FIST LARYNX REVIS LARYNGOSTOMY REPR LARYNGEAL FX OTH REPR LARYNX RECON TRACH-CONSTRUCT ART LARYNX OTH REPR & PLSTC OPER TRACHEA DIVIS LARYNGEAL NERV LYSIS TRACHEA/LARYNX ADHES REPLCMT LARYNGEAL/TRACHEAL STENT TRACHEOESOPHAGEAL FISTULIZATION OTH OPER LARYNX ENDO EXC/DESTRUC LES/TISS BRONCHUS OTH LOC EXC/DEST LES/TISS BRONCH OTH EXC BRONCHUS THORASCOPIC EXCISION LESION/TISSUE LUNG PLICATION EMPHYSEMATOUS BLEB LUNG VOL REDUC SURG OPEN ABLATION LUNG LESION PERC ABLATION LUNG LESION THORASCOPIC ABLATION LUNG LES/TISS ABLATION LUNG LESION NEC & NOS ENDO EXC/DESTRUC LES/TISS LUNG OTH LOC EXC/DEST LES/TISS LUNG THORASCOPIC SEGMENTAL RESECTION LUNG THORASCOPIC LOBECTOMY OF LUNG OTHER LOBECTOMY OF LUNG THORASCOPIC PNEUMONECTOMY OTHER AND UNSPECIFIED PNEUMONECTOMY SEGMENTAL RESECT LUNG LOBEC LUNG COMPLT PNEUMONECTOMY RAD DISSECTION THOR STRUCT OTH EXC LUNG INCIS LUNG

A 06

D 06

A 07

OCT 07

OCT 06 OCT 06 OCT 06 OCT 06

OCT 07 OCT 07 OCT 07 OCT 07 OCT 07

D 07

Appendix F – ICD Codes for Measures #1 and #2

ICD Code 3320 3328 3329 3332 3333 3334 3339 3349 3350 3351 336 3393 3399 3401 3402 3403 3404 3405 3406 3409 3420 3421 3423 3424 3427 3428 344 3451 3452 3459 346 3473 3474 3479 3481 3483 3484 3485 3489 3492

Code Description THORASCOPIC LUNG BIOPSY OP BX LUNG OTH DX PROC LUNG & BRONCHUS ARTIFICIAL PNEUMOTHOR-COLLAPSE LUNG PNEUMOPERITONEUM-COLLAPSE LUNG THORACOPLASTY OTH SURG LUNG COLLAPSE OTH REPR & PLSTC OPER LUNG LUNG TRANSPL-NOS UNILAT LUNG TRANSPL COMBO HEART-LUNG TRANSPL PUNCT LUNG OTH OPER LUNG INCIS CHEST WALL EXPLOR THORACOTOMY REOPEN RECENT THORACOTOMY SITE INSRT INTERCOSTAL DRAIN CATH CREATE PLEUROPERITONEAL SHUNT THORASCOPIC DRAINAGE OF PLEURAL CAVITY OTH INCIS PLEURA THORASCOPIC PLEURAL BIOPSY TRANSPLEURAL THORACOSCOPY BX CHEST WALL PLEURAL BX BX DIAPHRAGM OTH DX CHEST WALL-PLEURA-DIAPHRAGM EXC/DESTRUC LES CHEST WALL DECORTIC LUNG THORASCOPIC DECORTICATION OF LUNG OTH EXC PLEURA SCARIFICATION PLEURA CLO OTH FIST-THOR REPR PECTUS DEFORM OTH CHEST WALL REPR EXC LES/TISS-DIAPHRAGM CLO FIST DIAPHRAGM OTH REPR DIAPHRAGM IMPLNT DIAPHRAGMATIC PACEMAKER OTH OPER DIAPHRAGM INJ THOR CAVITY

A 06

D 06

A 07 OCT 07

OCT 07 OCT 07

OCT 07

D 07

Appendix F – ICD Codes for Measures #1 and #2

ICD Code 3493 3499 3800 3801 3802 3803 3804 3805 3806 3807 3808 3809 3810 3811 3812 3814 3815 3816 3818 3821 3822 3830 3831 3832 3833 3834 3835 3836 3837 3838 3839 3840 3841 3842 3843 3844 3845 3846 3847 3848 3849

Code Description REPR PLEURA OTH OPER THOR INCISION OF VESSEL UNSPECIFIED SITE INCIS INTRACRAN VESSELS INCIS OTH VESSELS HEAD & NECK INCIS UPPER LIMB VESSELS INCIS AORTA INCIS OTH THOR VESSELS INCIS ABD ART INCIS ABD VEINS INCIS LOWER LIMB ART INCIS LOWER LIMB VEINS ENDARTERECTOMY UNS SITE ENDARTERECT INTRACRAN VESSEL ENDARTERECT OTH VESSELS HEAD-NECK ENDARTERECTOMY AORTA ENDARTERECT OTH THOR VESSELS ENDARTERECTOMY ABD ART ENDARTERECTOMY LOWER LIMB ART BX BLD VESSEL PERCUT ANGIOSCOPY RESECT VESSEL W/ANASTOM UNS SITE RESECT INTRACRAN VESSELS-ANASTOM RESECT OTH HEAD-NECK VESSEL-ANASTOM RESECT UP LIMB VESSELS W/ANASTOM RESECT AORTA W/ANASTOM RESECT OTH THOR VESSELS-ANASTOM RESECT ABD ART W/ANASTOM RESECT ABD VEINS W/ANASTOM RESECT LOWER LIMB ART W/ANASTOM RESECT LOWER LIMB VEINS W/ANASTOM RESECT VESSEL W/REPLCMT UNS SITE RESECT INTRACRAN VESSELS-REPLCMT RESECT OTH HEAD-NECK VESSEL-REPLCMT RESECT UPPER LIMB VESSELS W/REPLCMT RESECT ABD AORTA W/REPLCMT RESECT OTH THOR VESSELS W/REPLCMT RESECT ABD ART W/REPLCMT RESECT ABD VEINS W/REPLCMT RESECT LOWER LIMB ART W/REPLCMT RESECT LOWER LIMB VEINS W/REPLCMT

A 06

D 06

A 07

D 07

Appendix F – ICD Codes for Measures #1 and #2

ICD Code 3850 3851 3852 3853 3855 3857 3859 3860 3861 3862 3863 3864 3865 3866 3867 3868 3869 387 3880 3881 3882 3883 3884 3885 3886 3887 3888 3891 3892 3894 3898 3899 390 391 3921 3922 3923 3924 3925 3929 3974

Code Description LIG & STRIP VARICOSE VEINS-UNS SITE LIG-STRIP VARICOSE VEINS-INTRACRAN LIG-STRIP VARICOSE VEINS HEAD-NECK LIG-STRIP VARICOSE VEINS-UP LIMB LIG-STRIP VARICOSE VEINS-THOR LIG-STRIP VARICOSE VEINS-ABD VEINS LIG-STRIP VARICOSE VEINS-LOWER LIMB OTH EXC VESSELS UNS SITE OTH EXC INTRACRAN VESSELS OTH EXC OTH VESSELS HEAD & NECK OTH EXC UPPER LIMB VESSELS OTH EXC ABD AORTA OTH EXC THOR VESSEL OTH EXC ABD ART OTH EXC ABD VEINS OTH EXC LOWER LIMB ART OTH EXC LOWER LIMB VEINS INTERRUPTION VENA CAVA OTH SURG OCCLU VESSELS-UNS SITE OTH SURG OCCLU-INTRACRAN VESSEL OTH OCCLU-OTH VESSEL HEAD-NECK OTH SURG OCCLU-UP LIMB VESSEL OTH SURG OCCLU-ABD AORTA OTH SURG OCCLU-THOR VESSEL OTH SURG OCCLU-ABD ART OTH SURG OCCLU-ABD VEINS OTH SURG OCCLU-LOWER LIMB ART ART CATH UMB VEIN CATH VENOUS CUTDN OTH PUNCT ART OTH PUNCT VEIN SYSTEMIC-PULM ART SHUNT INTRA-ABD-VENOUS SHUNT CAVAL-PULM ART ANASTOM AORTA-SUBCLAVIAN-CAROTID BYPASS OTH INTRATHOR VASC SHUNT/BYPASS AORTA-RENAL BYPASS AORTA-ILIAC-FEM BYPASS OTH (PERIPH) VASC SHUNT/BYPASS ENDOV RMVL HEAD/NECK VESS OBSTR

A 06

OCT 06

D 06

A 07

D 07

Appendix F – ICD Codes for Measures #1 and #2

ICD Code 3979 398 3990 3991 3992 3993 3994 3998 3999 400 4105 4106 4107 4108 4109 4138 4191 4192 4198 5300 5301 5302 5303 5304 5305 5321 5329 5501 5502 5503 5504 5511 5512 5523 5524 5529 5531 5539 554 5551 5552

Code Description OTH ENDOVASCULAR REPAIR OTH VESSELS OPER CAROTID BODY-OTH VASC BODIES INSRT NON-RX-ELUT PERIPH VES STENTS FREEING VESSEL INJ VEIN W/SCLEROSING AGENT INSRT VESSEL-TO-VESSEL CANNULA REPLCMT VESSEL-TO-VESSEL CANNULA CNTRL HEMORR-NOS OTH OPER VESSELS INCIS LYMPHATIC STRUCT ALLO HEMAT ST CELL TRNSPLT W/O PURG CORD BLD STEM CELL TRANSPL AUTO HEMAT ST CELL TRNSPLT W PURG ALLO HEMAT ST CELL TRNSPLT W PURG AUTO BONE MARR TRNSPLT W PURG OTH DX PROC BONE MARROW ASPIR DONOR BONE MARROW TRANSPL INJ BONE MARROW OTH OPER BONE MARROW UNILAT REPR ING HERN-NOS UNILAT REPR DIRECT ING HERN UNILAT REPR INDIRECT ING HERN UNILAT REPR DIRECT ING HERN-GFT UNILAT REPR INDIRECT ING HERN-GFT UNILAT REPR ING HERN-GFT-NOS UNILAT REPR FEM HERN W/GFT/PROSTH OTH UNILAT FEM HERNIORRHAPHY NEPHROTOMY NEPHROSTOMY PERCUT NEPHROSTOMY WO FRAGMENT PERCUT NEPHROSTOMY W/FRAGMENT PYELOTOMY PYELOSTOMY CLO [PERCUT] [NEEDLE] BX KIDNEY OP BX KIDNEY OTH DX PROC KIDNEY MARSUP KIDNEY LES OTH LOC DEST/EXC RENAL LES/TISS PART NEPHRECTOMY NEPHROURETERECTOMY NEPHRECTOMY REMAINING KIDNEY

A 06

D 06

A 07

D 07

Appendix F – ICD Codes for Measures #1 and #2

ICD Code 5553 5554 5561 5569 557 5582 5583 5584 5585 5586 5587 5589 5591 5592 5593 5594 5595 5596 5597 5598 5599 5632 5634 5640 5641 5642 5672 5673 5681 5684 5685 5686 5689 5691 5692 5693 5694 5695 6501 6509 6511

Code Description REMOV TRANSPL/REJECTED KIDNEY BILAT NEPHRECTOMY RENAL AUTOTRANSPL OTH KIDNEY TRANSPL NEPHROPEXY CLO NEPHROSTOMY & PYELOSTOMY CLO OTH KIDNEY FIST REDUC TORSION RENAL PEDICLE SYMPHYSIOTOMY HORSESHOE KIDNEY ANASTOM KIDNEY CORRECT URETEROPELVIC JUNCTION OTH REPR KIDNEY DECAPSULATION KIDNEY PERCUT ASPIR KIDNEY (PELV) REPLCMT NEPHROSTOMY TUBE REPLCMT PYELOSTOMY TUBE LOC PERFUSION KIDNEY OTH INJ THERAP SUBSTANCE KIDNEY IMPLNT/REPLCMT MECH KIDNEY REMOV MECH KIDNEY OTH OPER KIDNEY CLO PERCUT BX URETER OP BX URETER URETERECTOMY-NOS PART URETERECTOMY TOT URETERECTOMY REVIS URETEROINTESTINAL ANASTOM NEPHROCYSTANASTOMOSIS-NOS LYSIS INTRALUMINAL URETER ADHES CLO OTH FIST URETER URETEROPEXY REMOV LIG URETER OTH REPR URETER DILAT URETERAL MEATUS IMPLNT ELECTRONIC URETERAL STIM REPLCMT ELECTRONIC URETERAL STIM REMOV ELECTRONIC URETERAL STIM LIG URETER LAP OOPHOROTOMY OTH OOPHORECTOMY ASPIR BX OVARY

A 06

D 06 APRIL 07

A 07

D 07

Appendix F – ICD Codes for Measures #1 and #2

ICD Code 6512 6513 6514 6519 6521 6522 6523 6524 6525 6529 6531 6539 6541 6549 6552 6562 6564 6572 6573 6576 6579 6581 6589 6591 6592 6593 6594 6595 6599 6601 6602 6611 6619 664 6652 6661 6662 6663 6669 6672 6673

Code Description OTH BX OVARY LAP BX OVARY OTH LAP DX PROC OVARIES OTH DX PROC OVARIES MARSUP OVARIAN CYST WEDGE RESECT OVARY LAP MARSUP OVARIAN CYST LAP WEDGE RESECT OVARY OTH LAP LOC EXC/DESTRUC OVARY OTH LOC EXC/DESTRUC OVARY LAP UNILAT OOPHORECTOMY OTH UNILAT OOPHORECTOMY LAP UNILAT SALPINGO-OOPHORECTOMY OTH UNILAT SALPINGO-OOPHORECTOMY OTH REMOV REMAINING OVARY OTH REMOV REMAINING OVARY & TUBE LAP REMOV REMAINING OVARY & TUBE OTH REIMPLNT OVARY OTH SALPINGO-OOPHOROPLASTY LAP SALPINGO-OOPHOROPLASTY OTH REPR OVARY LAP LYSIS OVARY-FALLOP TUBE ADHES OTH LYSIS OVARY-FALLOP TUBE ADHES ASPIR OVARY TRANSPL OVARY MANUAL RUPT OVARIAN CYST OVARIAN DENERVATION RELEASE TORSION OVARY OTH OPER OVARY SALPINGOTOMY SALPINGOSTOMY BX FALLOPIAN TUBE OTH DX PROC FALLOPIAN TUBES TOT UNILAT SALPINGECTOMY REMOV REMAINING FALLOPIAN TUBE EXC/DESTRUC LES FALLOPIAN TUBE SALPINGECTOMY W/REMOV TUBAL PG BILAT PART SALPINGECTOMY-NOS OTH PART SALPINGECTOMY SALPINGO-OOPHOROSTOMY SALPINGO-SALPINGOSTOMY

A 06

D 06

APRIL 07

A 07

D 07

Appendix F – ICD Codes for Measures #1 and #2

ICD Code 6674 668 6691 6692 6693 6694 6695 6696 6697 6699 7601 7609 7611 7619 762 7631 7639 7643 7644 7646 765 7670 7671 7672 7673 7674 7675 7676 7677 7678 7679 7691 7692 7693 7694 7695 7696 7697 7699 7700 7701

Code Description SALPINGO-UTEROSTOMY INSUFFLATION FALLOPIAN TUBE ASPIR FALLOPIAN TUBE UNILAT DEST/OCCLU FALLOPIAN TUBE IMPLNT/REPLCE PROSTH FALLOP TUBE REMOV PROSTH FALLOPIAN TUBE INSUFFLAT THERAP AGENT FALLOP TUBES DILAT FALLOPIAN TUBE BURY FIMBRIAE UTERINE WALL OTH OPER FALLOPIAN TUBES SEQUESTREC FACIAL BONE OTH INCIS FACIAL BONE BX FACIAL BONE OTH DX PROC FACIAL BONES & JT LOC EXC/DESTRUC LES FACIAL BONE PART MANDIBULECTOMY PART OSTEC OTH FACIAL BONE OTH RECON MANDIB TOT OSTEC OTH FACIAL BONE-RECON OTH RECON OTH FACIAL BONE TEMPOROMANDIB ARTHROPLSTY REDUC FACIAL FX-NOS CLO REDUC MALAR & ZYGO FX OP REDUC MALAR & ZYGO FX CLO REDUC MAXIL FX OP REDUC MAXIL FX CLO REDUC MANDIB FX OP REDUC MANDIB FX OP REDUC ALVEOL FX OTH CLO REDUC FACIAL FX OTH OP REDUC FACIAL FX BONE GFT FACIAL BONE INSRT SYNTHETIC IMPLNT FACIAL BONE CLO REDUC TEMPOROMANDIB DISLOC OP REDUC TEMPOROMANDIB DISLOC OTH MANIP TMJ INJ THERAP SUBSTANCE TMJ REMOV INT FIX DEVICE FACIAL BONE OTH OPER FACIAL BONES & JT SEQUESTREC-UNS SITE SEQUESTREC-SCAPULA-CLAV-THOR

A 06

D 06

A 07

D 07

Appendix F – ICD Codes for Measures #1 and #2

ICD Code 7702 7703 7704 7705 7706 7707 7708 7709 7710 7711 7712 7713 7714 7715 7716 7717 7718 7719 7720 7721 7722 7723 7724 7725 7726 7727 7729 7730 7731 7732 7733 7734 7735 7736 7737 7738 7739 7740 7741 7742 7743

Code Description SEQUESTREC-HUMERUS SEQUESTREC-RADIUS & ULNA SEQUESTREC-CARPALS & METACARPALS SEQUESTREC-FEM SEQUESTREC-PATELLA SEQUESTREC-TIBIA & FIB SEQUESTREC-TARSALS & METATARSALS SEQUESTREC-OTH BONE OTH INCIS BONE WO DIVIS-UNS SITE OTH INCIS WO DIVIS-SCAPLA-CLAV-THOR OTH INCIS WO DIVIS-HUMERUS OTH INCIS WO DIVIS-RADIUS & ULNA OTH INCIS WO DIVIS-CARP-METACARP OTH INCIS WO DIVIS-FEM OTH INCIS WO DIVIS-PATELLA OTH INCIS WO DIVIS-TIBIA & FIB OTH INCIS WO DIVIS-TARSAL-METATARS OTH INCIS WO DIVIS-OTH BONE WEDGE OSTEOT-UNS SITE WEDGE OSTEOT-SCAPULA-CLAV & THOR WEDGE OSTEOT-HUMERUS WEDGE OSTEOT-RADIUS & ULNA WEDGE OSTEOT-CARPALS & METACARPALS WEDGE OSTEOT-FEM WEDGE OSTEOT-PATELLA WEDGE OSTEOT-TIBIA & FIB WEDGE OSTEOT-OTH BONE OTH DIVIS BONE-UNS SITE OTH DIVIS-SCAPULA-CLAV-THOR OTH DIVIS-HUMERUS OTH DIVIS-RADIUS & ULNA OTH DIVIS-CARPALS & METACARPALS OTH DIVIS-FEM OTH DIVIS-PATELLA OTH DIVIS-TIBIA & FIB OTH DIVIS-TARSALS & METATARSALS OTH DIVIS-OTH BONE BX BONE-UNS SITE BX-SCAPULA-CLAV & THOR BX-HUMERUS BX-RADIUS & ULNA

A 06

D 06

A 07

D 07

Appendix F – ICD Codes for Measures #1 and #2

ICD Code 7744 7745 7746 7747 7748 7749 7751 7752 7753 7754 7756 7757 7758 7759 7760 7761 7762 7763 7764 7765 7766 7767 7768 7769 7770 7771 7772 7773 7774 7775 7776 7777 7778 7779 7780 7781 7782 7783 7784 7785 7786

Code Description BX-CARPALS & METACARPALS BX-FEM BX-PATELLA BX-TIBIA & FIB BX-TARSALS & METATARSALS BX-OTH BONE BUNIONEC SOFT-OSTEOT 1ST METATARS BUNIONEC-SOFT TIS-ARTHRODESIS OTH BUNIONEC W/SOFT TISS CORRECT EXC/CORRECT BUNIONETTE REPR HAMMER TOE REPR CLAW TOE OTH EXC-FUSION & REPR TOES OTH BUNIONEC LOC EXC LES/TISS-BONE-UNS SITE LOC EXC LES SCAPULA-CLAV & THOR LOC EXC LES/TISS-HUMERUS LOC EXC LES/TISS-RADIUS & ULNA LOC EXC LES/TISS-CARP-METACARP LOC EXC LES/TISS-FEM LOC EXC LES/TISS-PATELLA LOC EXC LES/TISS-TIBIA & FIB LOC EXC LES/TISS-TARS-METATARS LOC EXC LES/TISS-OTH BONE EXC-BONE GFT-UNS SITE EXC BONE GFT-SCAPULA-CLAV-THOR EXC BONE GFT-HUMERUS EXC BONE GFT-RADIUS & ULNA EXC BONE GFT-CARPALS-METACARPALS EXC BONE GFT-FEM EXC BONE GFT-PATELLA EXC BONE GFT-TIBIA & FIB EXC BONE GFT-TARSALS-METATARSALS EXC BONE GFT-OTH BONE OTH PART OSTEC-UNS SITE OTH PART OSTEC-SCAPULA-CLAV-THOR OTH PART OSTEC-HUMERUS OTH PART OSTEC-RADIUS & ULNA OTH PART OSTEC-CARPALS-METACARPALS OTH PART OSTEC-FEM OTH PART OSTEC-PATELLA

A 06

D 06

A 07

D 07

Appendix F – ICD Codes for Measures #1 and #2

ICD Code 7787 7788 7790 7791 7792 7793 7794 7795 7796 7797 7798 7799 7800 7801 7802 7803 7804 7805 7806 7807 7808 7809 7810 7811 7812 7813 7814 7815 7816 7817 7818 7819 7820 7822 7823 7824 7825 7827 7828 7829 7830

Code Description OTH PART OSTEC-TIBIA & FIB OTH PART OSTEC-TARSALS-METATARSALS TOT OSTEC-UNS SITE TOT OSTEC-SCAPULA-CLAV-THOR TOT OSTEC-HUMERUS TOT OSTEC-RADIUS & ULNA TOT OSTEC-CARPALS & METACARPALS TOT OSTEC-FEM TOT OSTEC-PATELLA TOT OSTEC-TIBIA & FIB TOT OSTEC-TARSALS & METATARSALS TOT OSTEC OTH BONE BONE GFT-UNS SITE BONE GFT-SCAPULA-CLAV & THOR BONE GFT-HUMERUS BONE GFT-RADIUS & ULNA BONE GFT-CARPALS & METACARPALS BONE GFT-FEM BONE GFT-PATELLA BONE GFT-TIBIA & FIB BONE GFT-TARSALS & METATARSALS BONE GFT-OTH BONE APPLIC EXT FIX DEVICE-UNS SITE APPLIC EXT FIX-SCAPULA-CLAV-THOR APPLIC EXT FIX DEVICE-HUMERUS APPLIC EXT FIX DEVICE-RADIUS & ULNA APPLIC EXT FIX DEVICE-CARP-METACARP APPLIC EXT FIX DEVICE-FEM APPLIC EXT FIX DEVICE-PATELLA APPLIC EXT FIX DEVICE-TIBIA & FIB APPLIC EXT FIX-TARSALS-METATARSALS APPLIC EXT FIX DEVICE-OTH BONE LIMB SHORTEN PROC-UNS SITE LIMB SHORTEN PROC-HUMERUS LIMB SHORTEN PROC-RADIUS & ULNA LIMB SHORTEN PROC-CARPAL-METACARPAL LIMB SHORTEN PROC-FEM LIMB SHORTEN PROC-TIBIA & FIB LIMB SHORTEN PROC-TARSAL-METATARSAL LIMB SHORTEN PROC-OTH BONE LIMB LENGTHEN PROC-UNS SITE

A 06

D 06

A 07

D 07

Appendix F – ICD Codes for Measures #1 and #2

ICD Code 7832 7833 7834 7835 7837 7838 7839 7840 7841 7842 7843 7844 7845 7846 7847 7848 7850 7851 7852 7853 7854 7855 7856 7857 7858 7859 7860 7861 7862 7863 7864 7865 7866 7867 7868 7869 7870 7871 7872 7873 7874

Code Description LIMB LENGTHEN PROC-HUMERUS LIMB LENGTHEN PROC-RADIUS & ULNA LIMB LENGTHEN PROC-CARP-METACARP LIMB LENGTHEN PROC-FEM LIMB LENGTHEN PROC-TIBIA & FIB LIMB LENGTHEN PROC-TARS-METATARS LIMB LENGTHEN PROC-OTH BONE OTH REPR/PLSTC OPER BONE-UNS SITE OTH REPR OPER-SCAPULA-CLAV & THOR OTH REPR/PLSTC OPER-HUMERUS OTH REPR/PLSTC OPER-RADIUS & ULNA OTH REPR OPER-CARPALS-METACARPALS OTH REPR/PLSTC OPER-FEM OTH REPR/PLSTC OPER-PATELLA OTH REPR/PLSTC OPER-TIBIA & FIB OTH REPR OPER-TARSALS-METATARSALS INT FIX-BONE WO FX REDUC-UNS SITE INT FIX WO REDUC-SCAPULA-CLAV-THOR INT FIX WO FX REDUC-HUMERUS INT FIX WO FX REDUC-RADIUS & ULNA INT FIX WO REDUC-CARPAL-METACARPAL INT FIX WO FX REDUC-FEM INT FIX WO FX REDUC-PATELLA INT FIX WO FX REDUC-TIBIA & FIB INT FIX WO REDUC-TARSAL-METATARSAL INT FIX WO FX REDUC-OTH BONE REMOV IMPLNT DEVICE-UNS SITE REMOV IMPLNT-SCAPULA-CLAV-THOR REMOV IMPLNT DEVICE-HUMERUS REMOV IMPLNT DEVICE-RADIUS & ULNA REMOV IMPLNT DEVICE-CARP-METACARP REMOV IMPLNT DEVICE-FEM REMOV IMPLNT DEVICE-PATELLA REMOV IMPLNT DEVICE-TIBIA & FIB REMOV IMPLNT DEVICE-TARS-METATARS REMOV IMPLNT DEVICE-OTH BONE OSTEOCLASIS-UNS SITE OSTEOCLASIS-SCAPULA-CLAV-THOR OSTEOCLASIS-HUMERUS OSTEOCLASIS-RADIUS & ULNA OSTEOCLASIS-CARPALS & METACARPALS

A 06

D 06

A 07

D 07

Appendix F – ICD Codes for Measures #1 and #2

ICD Code 7875 7876 7877 7878 7879 7880 7881 7882 7883 7884 7885 7886 7887 7888 7889 7890 7891 7892 7893 7894 7895 7896 7897 7898 7899 7920 7921 7922 7923 7924 7925 7926 7927 7928 7929 7930 7931 7932 7933 7934 7935

Code Description OSTEOCLASIS-FEM OSTEOCLASIS-PATELLA OSTEOCLASIS-TIBIA & FIB OSTEOCLASIS-TARSALS & METATARSALS OSTEOCLASIS-OTH BONE DX PROC BONE-NEC-UNS SITE DX PROC-NEC-SCAPULA-CLAV-THOR DX PROC-NEC-HUMERUS DX PROC-NEC-RADIUS & ULNA DX PROC-NEC-CARPALS & METACARPALS DX PROC-NEC-FEM DX PROC-NEC-PATELLA DX PROC-NEC-TIBIA & FIB DX PROC-NEC-TARSALS & METATARSALS DX PROC-NEC-OTH BONE INSRT BONE GROWTH STIM-UNS SITE INSRT GROWTH STIM-SCAPULA-CLAV-THOR INSRT BONE GROWTH STIM-HUMERUS INSRT BONE GROWTH STIM-RADIUS-ULNA INSRT GROWTH STIM-CARPAL-METACARPAL INSRT BONE GROWTH STIM-FEM INSRT BONE GROWTH STIM-PATELLA INSRT BONE GROWTH STIM-TIBIA & FIB INSRT GROWTH STIM-TARSAL-METATARSAL INSRT BONE GROWTH STIM-OTH BONE OP REDUC FX WO INT FIX-UNS SITE OP REDUC FX WO INT FIX-HUMERUS OP REDUC WO INT FIX-RADIUS & ULNA OP REDUC WO INT FIX-CARP-METACARP OP REDUC WO INT FIX-PHALANGES HAND OP REDUC FX WO INT FIX-FEM OP REDUC FX WO INT FIX-TIBIA & FIB OP REDUC WO INT FIX-TARS-METATARS OP REDUC FX WO INT FIX-PHALANGES FT OP REDUC FX WO INT FIX-OTH BONE OP REDUC FX W/INT FIX-UNS SITE OP REDUC FX W/INT FIX-HUMERUS OP REDUC FX W/INT FIX-RADIUS & ULNA OP REDUC W/INT FIX-CARP-METACARP OP REDUC W/INT FIX-PHALANGES HAND OP REDUC FX W/INT FIX-FEM

A 06

D 06

A 07

D 07

Appendix F – ICD Codes for Measures #1 and #2

ICD Code 7936 7937 7938 7939 7940 7941 7942 7945 7949 7950 7951 7952 7955 7956 7959 7980 7981 7982 7983 7984 7985 7986 7987 7988 7989 7990 7991 7992 7993 7994 7995 7996 7997 7998 7999 8000 8001 8002 8003 8004 8005

Code Description OP REDUC FX W/INT FIX-TIBIA & FIB OP REDUC W/INT FIX-TARS-METATARS OP REDUC FX W/INT FIX-PHALANGES FT OP REDUC FX W/INT FIX-OTH BONE CLO REDUC SEPART EPIPHYSIS-UNS SITE CLO REDUC SEPART EPIPHYSIS-HUMERUS CLO REDUC SEPART EPIPHYSIS-RAD-ULNA CLO REDUC SEPART EPIPHYSIS-FEM CLO REDUC SEPART EPIPHYSIS-OTH BONE OP REDUC SEPART EPIPHYSIS-UNS SITE OP REDUC SEPART EPIPHYSIS-HUMERUS OP REDUC SEPART EPIPHYSIS-RAD-ULNA OP REDUC SEPART EPIPHYSIS-FEM OP REDUC SEPART EPIPHYSIS-TIBIA-FIB OP REDUC SEPART EPIPHYSIS-OTH BONE OP REDUC DISLOC-UNS SITE OP REDUC DISLOC-SHLDR OP REDUC DISLOC-ELB OP REDUC DISLOC-WRIST OP REDUC DISLOC-HAND & FINGR OP REDUC DISLOC-HIP OP REDUC DISLOC-KNEE OP REDUC DISLOC-ANK OP REDUC DISLOC-FT & TOE OP REDUC DISLOC-OTH SPEC SITE UNS OPER BONE INJURY-UNS SITE UNS OPER BONE INJURY-HUMERUS UNS OPER BONE INJURY-RADIUS & ULNA UNS OPER BONE INJURY-CARP-METACARP UNS OPER BONE INJURY-PHALANGES HAND UNS OPER BONE INJURY-FEM UNS OPER BONE INJURY-TIBIA & FIB UNS OPER BONE INJURY-TARS-METATARS UNS OPER BONE INJURY-PHALANGES FT UNS OPER BONE INJURY-OTH SPEC BONE ARTHROT REMOV PROSTH-UNS SITE ARTHROT REMOV PROSTH-SHLDR ARTHROT REMOV PROSTH-ELB ARTHROT REMOV PROSTH-WRIST ARTHROT REMOV PROSTH-HAND & FINGR ARTHROT REMOV PROSTH-HIP

A 06

D 06

A 07

D 07

Appendix F – ICD Codes for Measures #1 and #2

ICD Code 8007 8008 8009 8010 8011 8012 8013 8014 8015 8016 8017 8018 8019 8020 8021 8022 8023 8024 8025 8026 8027 8028 8029 8030 8031 8032 8033 8034 8035 8036 8037 8038 8039 8040 8041 8042 8043 8044 8045 8046 8047

Code Description ARTHROT REMOV PROSTH-ANK ARTHROT REMOV PROSTH-FT & TOE ARTHROT REMOV PROSTH-OTH SPEC SITE OTH ARTHROT-UNS SITE OTH ARTHROT-SHLDR OTH ARTHROT-ELB OTH ARTHROT-WRIST OTH ARTHROT-HAND & FINGR OTH ARTHROT-HIP OTH ARTHROT-KNEE OTH ARTHROT-ANK OTH ARTHROT-FT & TOE OTH ARTHROT-OTH SPEC SITE ARTHSCPY-UNS SITE ARTHSCPY-SHLDR ARTHSCPY-ELB ARTHSCPY-WRIST ARTHSCPY-HAND & FINGR ARTHSCPY-HIP ARTHSCPY-KNEE ARTHSCPY-ANK ARTHSCPY-FT & TOE ARTHSCPY-OTH SPEC SITE BX JT STRUCT-UNS SITE BX JT STRUCT-SHLDR BX JT STRUCT-ELB BX JT STRUCT-WRIST BX JT STRUCT-HAND & FINGR BX JT STRUCT-HIP BX JT STRUCT-KNEE BX JT STRUCT-ANK BX JT STRUCT-FT & TOE BX JT STRUCT-OTH SPEC SITE DIVIS JT CAP-LIGAMNT/CART-UNS SITE DIVIS JT CAP-LIGAMNT/CART-SHLDR DIVIS JT CAP-LIGAMNT/CART-ELB DIVIS JT CAP-LIGAMNT/CART-WRIST DIVIS JT CAP-LIGAMNT/CART-HND-FINGR DIVIS JT CAP-LIGAMNT/CART-HIP DIVIS JT CAP-LIGAMNT/CART-KNEE DIVIS JT CAP-LIGAMNT/CART-ANK

A 06

D 06

A 07

D 07

Appendix F – ICD Codes for Measures #1 and #2

ICD Code 8048 8049 8050 8051 8052 8059 806 8070 8071 8072 8073 8074 8075 8076 8077 8078 8079 8080 8081 8082 8084 8085 8086 8087 8088 8089 8090 8091 8092 8093 8094 8095 8096 8097 8098 8099 8100 8101 8102 8103 8104

Code Description DIVIS JT CAP-LIGAMNT/CART-FT & TOE DIVIS JT CAP-LIGAMNT/CART-OTH SITE EXC/DESTRUC INTERVERTEBRAL DISC-UNS EXC INTERVERTEBRAL DISC INTERVERTEBRAL CHEMONUCLEOLYSIS OTH DESTRUC INTERVERTEBRAL DISC EXC SEMILUNAR CARTILAGE-KNEE SYNOVECT-UNS SITE SYNOVECT-SHLDR SYNOVECT-ELB SYNOVECT-WRIST SYNOVECT-HAND & FINGR SYNOVECT-HIP SYNOVECT-KNEE SYNOVECT-ANK SYNOVECT-FT & TOE SYNOVECT-OTH SPEC SITE OTH LOC EXC/DEST JT LES-UNS SITE OTH LOC EXC/DESTRUC JT LES-SHLDR OTH LOC EXC/DESTRUC JT LES-ELB OTH LOC EXC/DEST JT LES-HND-FINGR OTH LOC EXC/DESTRUC JT LES-HIP OTH LOC EXC/DESTRUC JT LES-KNEE OTH LOC EXC/DESTRUC JT LES-ANK OTH LOC EXC/DEST JT LES-FT-TOE OTH LOC EXC/DEST JT LES-OTH SITE OTH EXC JT-UNS SITE OTH EXC JT-SHLDR OTH EXC JT-ELB OTH EXC JT-WRIST OTH EXC JT-HAND & FINGR OTH EXC JT-HIP OTH EXC JT-KNEE OTH EXC JT-ANK OTH EXC JT-FT & TOE OTH EXC-JT OTH SPEC SITE SPINAL FUSION-NOS ATLAS-AXIS SPINAL FUSION OTH CERV FUSION-ANT TECH OTH CERV FUSION-POST TECH DORSAL-DORSOLUMBAR FUS-ANT TECH

A 06

D 06

A 07

D 07

Appendix F – ICD Codes for Measures #1 and #2

ICD Code 8105 8106 8107 8108 8111 8112 8113 8114 8115 8116 8117 8120 8121 8122 8123 8124 8125 8126 8127 8128 8129 8130 8131 8132 8133 8134 8135 8136 8137 8138 8139 8140 8142 8143 8144 8145 8146 8147 8149 8151 8152

Code Description DORSAL-DORSOLUMBAR FUS-POST TECH LUMB & LUMBOSACRAL FUSION-ANT TECH LUMB-LUMBOSACRAL FUS-LAT TRANSVERSE LUMB-LUMBOSACRAL FUSION-POST TECH ANK FUSION TRIPLE ARTHRODESIS SUBTALAR FUSION MIDTARSAL FUSION TARSOMETATARSAL FUSION METATARSOPHALANGEAL FUSION OTH FUSION FT ARTHRODESIS UNS JT ARTHRODESIS HIP ARTHRODESIS KNEE ARTHRODESIS SHLDR ARTHRODESIS ELB CARPORADIAL FUSION METACARPOCARPAL FUSION METACARPOPHALANGEAL FUSION INTERPHALANGEAL FUSION ARTHRODESIS OTH SPEC JT REFUSION OF SPINE NOS REFUSION OF ATLAS-AXIS SPINE REFUSION OTH C-SPINE ANT TECHNIQUE REFUS OTH C-SPINE POST TECHNIQUE REFUS DORS&DORSOLUMB SPN ANT TECH REFUS DORS&DORSOLUMB SPN POST TECH REFUS LUMB&LUMBOSAC SPN ANT TECH REFUS LUMB&LUMBOSAC SPN LAT TRNS REFUS LUMB&LUMBOSAC SPN POST TECH REFUSION OF SPINE NEC REPR HIP-NEC 5-IN-1 KNEE REPR TRIAD KNEE REPR PATELLAR STABILIZATION OTH REPR CRUCIATE LIGAMNT OTH REPR COLLAT LIGAMNT OTH REPR KNEE OTH REPR ANK TOTAL HIP REPLACEMENT PART HIP REPLCMT

A 06

Correction

D 06

A 07

D 07

Appendix F – ICD Codes for Measures #1 and #2

ICD Code 8153 8154 8155 8156 8157 8159 8162 8163 8164 8165 8166 8171 8172 8173 8174 8175 8179 8180 8181 8182 8183 8184 8185 8191 8192 8301 8302 8303 8309 8311 8312 8313 8314 8319 8321 8329 8331 8332 8339 8341 8342

Code Description REVIS HIP REPLCMT TOT KNEE REPLCMT REVIS KNEE REPLCMT TOT ANK REPLCMT REPLCMT JT FT & TOE REVIS JT REPLCMT LOWER EXTREM-NEC FUSION OR REFUSION OF 2-3 VERTEBRAE FUSION OR REFUSION OF 4-8 VERTEBRAE FUSION/REFUSION 9/MORE VERTEBRAE VERTEBROPLASTY KYPHOPLASTY ARTHROPLSTY MCP-IP JT W/IMPLNT ARTHROPLSTY MCP-IP JT WO IMPLNT TOT WRIST REPLCMT ARTHRPLSTY CARPOCARPAL JT W/IMPLNT ARTHRPLSTY CARPOCARPAL JT WO IMPLNT OTH REPR HAND-FINGR & WRIST TOT SHLDR REPLCMT PART SHLDR REPLCMT REPR RECUR DISLOC SHLDR OTH REPR SHLDR TOT ELB REPLCMT OTH REPR ELB ARTHROCEN INJ THERAP SUBSTANCE JT/LIGAMNT EXPLOR TENDON SHEATH MYOTOMY BURSOTOMY OTH INCIS SOFT TISS ACHILLOTENOTOMY ADDUCTOR TENOT HIP OTH TENOT FASCIOTOMY OTH DIVIS SOFT TISS BX SOFT TISS OTH DX MUSC-TENDN-FASCIA-BURSA HAND EXC LES TENDON SHEATH EXC LES MUSC EXC LES OTH SOFT TISS EXC TENDON GFT OTH TENONECTOMY

A 06

D 06

A 07

D 07

Appendix F – ICD Codes for Measures #1 and #2

ICD Code 8343 8344 8345 8349 835 8362 8363 8371 8372 8373 8374 8375 8376 8377 8379 8381 8382 8383 8384 8385 8386 8387 8388 8389 8391 8392 8393 8395 8396 8397 8398 8400 8401 8402 8403 8404 8405 8406 8407 8408 8409

Code Description EXC MUSC/FASCIA GFT OTH FASCIECT OTH MYECTOMY OTH EXC SOFT TISS BURSECTOMY DELAYED SUT TENDON ROTATOR CUFF REPAIR ADVANCEMENT TENDON RECESSION TENDON REATTACHMENT TENDON REATTACHMENT MUSC TENDON TRANSF/TRANSPL OTH TENDON TRANSPOSITION MUSC TRANSF/TRANSPL OTH MUSC TRANSPOSITION TENDON GFT GFT MUSC/FASCIA TENDON PULLEY RECON RELEASE CLUB FT-NEC OTH CHANGE MUSC/TENDON LENGTH QUADRICEPSPLASTY OTH PLSTC OPER MUSC OTH PLSTC OPER TENDON OTH PLSTC OPER FASCIA LYSIS MUSC-TENDN-FASCIA-BURSA ADHES INSRT/REPLCMT SKEL MUSC STIM REMOV SKEL MUSC STIM ASPIR OTH SOFT TISS INJ THERAP SUBSTANCE BURSA INJ THERAP SUBSTANCE TENDON INJ LOC TX SUBSTNCE OTH SOFT TISS UPPER LIMB AMPUT-NOS AMPUT & DISART FINGR AMPUT & DISART THUMB AMPUT THRU HAND DISART WRIST AMPUT THRU FOREARM DISART ELB AMPUT THRU HUMERUS DISART SHLDR INTERTHORACOSCAPULAR AMPUT

A 06

Correction

D 06

A 07

D 07

Appendix F – ICD Codes for Measures #1 and #2

ICD Code 8410 8411 8412 8413 8414 8415 8416 8417 8418 8419 8421 8422 8423 8424 8425 8426 8427 8428 8429 843 8440 8441 8442 8443 8444 8445 8446 8447 8448 8451 8452 8453 8454 8455 8459 8460 8461 8462 8463 8464 8465

Code Description LOWER LIMB AMPUT-NOS AMPUT TOE AMPUT THRU FT DISART ANK AMPUT ANK THRU MALLEOLI TIBIA & FIB OTH AMPUT BELOW KNEE DISART KNEE AMPUT ABOVE KNEE DISART HIP ABDOMINOPELVIC AMPUT THUMB REATTACHMENT FINGR REATTACHMENT FOREARM-WRIST/HAND REATTACHMENT UPPER ARM REATTACHMENT TOE REATTACHMENT FT REATTACHMENT LOWER LEG/ANK REATTACHMENT THIGH REATTACHMENT OTH REATTACHMENT EXTREM REVIS AMPUT STUMP IMPLNT/FITTING PROSTH LIMB-NOS FITTING PROSTH UPPER ARM & SHLDR FITTING PROSTH LOWER ARM & HAND FITTING PROSTH ARM-NOS IMPLNT PROSTH DEVICE ARM FITTING PROSTH ABOVE KNEE FITTING PROSTH BELOW KNEE FITTING PROSTH LEG-NOS IMPLNT PROSTH DEVICE LEG INSERTION INTRBOD SPINAL FUS DEVICE INSRT RECOMB BN MORPHOGENETIC PROT IMPL INTRL LIMB LEN DEV KINET DSTRC IMPL OTH INTRL LIMB LEN DEVICE INSERTION OF BONE VOID FILLER INSERTION OF OTHER SPINAL DEVICES INSERTION SPINAL DISC PROSTH NOS INSRTION PART SP DISC PROSTH CERV INSRTION TOTAL SP DISC PROSTH CERV INSERTION SPINAL DISC PROSTH THOR INSRTION PART SP DISC PROS LUMBOSAC INSRTION TOT SP DISC PROS LUMBOSAC

A 06

D 06

A 07

D 07

Appendix F – ICD Codes for Measures #1 and #2

ICD Code 8466 8467 8468 8469 8480 8481 8482 8483 8484 8485 8491 850 8511 8512 8519 8520 8521 8522 8523 8524 8525 8531 8533 8534 8541 8543 8545 8547 8550 8551 8553 856 857 8582 8583 8584 8585 8586 8587 8589 8591

Code Description A 06 REV/REPL ARTFICL SP DISC PROS CERV REV/REPL ARTFICL SP DISC PROS THOR REV/REPL ARTF SP DISC PROS LUMBOSAC REV/REPL ARTFICL SP DISC PROS NOS INSERT/REPLACE INTERSPINOUS PROCESS REVISION INTERSPINOUS PROCESS DEVICES INSERTION/REPLACE PEDICLE-BASED DYNAMIC REVISION-BASED DYNAMIC STAB DEVICE INSERTION/REPLACEMENT FACET DEVICE REVISION FACET REPLACEMENT DEVICE AMPUT-NOS MASTOTOMYS CLO [PERCUT] [NEEDLE] BX BREAST OP BX BREAST OTH DX PROC BREAST EXC/DESTRUC BREAST TISS-NOS LOC EXC LES BREAST RESECT BREAST QUADRANT SUBTOT MASTEC EXC ECTOPIC BREAST TISS EXC NIPPLE UNILAT REDUC MAMMO UNILAT SUBQ MAMMECTOMY W/IMPLNT OTH UNILAT SUBQ MAMMECTOMY UNILAT SIMPL MASTEC UNILAT EXTEN SIMPL MASTEC UNILAT RAD MASTEC UNILAT EXTEN RAD MASTEC AUG MAMMO-NOS UNILAT AUG INJ BREAST UNILAT BREAST IMPLNT MASTOPEXY TOT RECON BREAST SPLIT-THICK GFT BREAST FULL-THICK GFT BREAST PEDICLE GFT BREAST MUSC FLAP GFT BREAST TRANSPOSITION NIPPLE OTH REPR/RECON NIPPLE OTH MAMMO ASPIR BREAST

D 06

A 07

OCT 07 OCT 07 OCT 07 OCT 07 OCT 07 OCT 07

D 07

Appendix F – ICD Codes for Measures #1 and #2

ICD Code 8592 8593 8594 8595 8596 8599 8601 8602 8603 8605 8609 8611 8619 8623 863 864 8660 8661 8662 8663 8664 8665 8666 8667 8670 8671 8672 8673 8674 8675 8681 8682 8683 8684 8685 8686 8689 8691 8692 8693 8694

Code Description INJ THERAP AGENT BREAST REVIS IMPLNT BREAST REMOV IMPLNT BREAST INSRT BREAST TISS EXPANDER REMOV BREAST TISS EXPANDER(S) OTH OPER BREAST ASPIR SKIN & SUBQ TISS INJ/TATTOOING SKIN LES/DEFEC INCIS PILONIDAL SINUS/CYST INCI W/REMOVL FB/DEVC SKN&SUBQ TISS OTH INCIS SKIN & SUBQ TISS BX SKIN & SUBQ TISS OTH DX PROC SKIN & SUBQ TISS REMOV NAIL-NAILBED/NAIL FOLD OTH LOC EXC LES SKIN-SUBQ TISS RAD EXC SKIN LES FREE SKIN GFT-NOS FULL-THICK SKIN GFT HAND OTH SKIN GFT HAND FULL-THICK SKIN GFT OTH SITES HAIR TRANSPL HETEROGRAFT SKIN HOMOGRAFT SKIN DERMAL REGENERATIVE GRAFT PEDICLE/FLAP GFT-NOS CUTTING & PREP PEDICLE GFT/FLAPS ADVANCEMENT PEDICLE GFT ATTACHMENT PEDICLE/FLAP GFT HAND ATTACH PEDICLE/FLAP GFT OTH SITES REVIS PEDICLE/FLAP GFT REPR FACIAL WEAKNESS FACIAL RHYTIDECTOMY SIZE REDUC PLSTC OPER RELAX SCAR/WEB CONTRACTURE SKIN CORRECT SYNDACTYLY ONYCHOPLASTY OTH REPR & RECON SKIN & SUBQ TISS EXC SKIN GFT ELECTROLYSIS & OTH EPILATION SKIN INSRT TISS EXPANDER INSRT/REPL 1 ARAY NEUROSTM PLSE GEN

A 06

D 06

A 07

D 07

Appendix F – ICD Codes for Measures #1 and #2

ICD Code 8695 8696

Code Description INSRT/REPL 2 ARAY NEUROSTM PLSE GEN INSRT/REPL OTH NEUROSTIM PULSE GEN

A 06

D 06

A 07

D 07

Appendix G – CPT Codes for Measures #1 and #2 *Codes with 50 modifier should be excluded as they are bilateral procedures

CPT Code 0016T 0017T 0027T 0046T 0047T 0061T 0077T 0090T 0091T 0092T 0093T 0094T 0095T 0096T 0097T 0098T 0099T 0100T 0163T 0164T 0165T 0171T 0172T 10021 10022 10040 10060 10061 10080 10081 10120 10121 10160 11043 11044 11055 11056 11057

A 07 CPT Description D 07 THERMOTX CHOROID VASC LESION PHOTOCOAGULAT MACULAR DRUSEN ENDOSCOPIC EPIDURAL LYSIS CATH LAVGE MAMM DUCT EA BRST;1 DUCT CATH LAVGE MAMM DUCT EA BRST;EA ADD DESTRUC MAL BRST TUMR MW THERMOTX IMPL&SECUR CERBRL THRML PRFUS PROBE TOT DISC ARTHPLSTY ANT 1; CERV TOT DISC ARTHPLSTY ANT 1; LUMB JAN 07 TOT DISC ARTHPLSTY ANT 1; EA ADD REMV TOT DISC ARTHPLSTY ANT 1;CERV REMV TOT DISC ARTHPLSTY ANT 1; LUMB JAN 07 REMV TOT DISC ARTHPLST ANT 1;EA ADD REV TOT DISC ARTHPLSTY ANT 1; CERV REV TOT DISC ARTHPLSTY ANT 1; LUMB JAN 07 REV TOT DISC ARTHPLSTY ANT 1;EA ADD IMPL INTRASTROMAL CORNEAL RING SEG PLCMT RET PROS&ELEC ARRAY W/VITRECT JAN 07 TOTAL DISC ARTHROPLASTY JAN 07 REMOVAL TOTAL DISC ARTHROPLASTY JAN 07 REVISION TOTAL DISC ARTHROPLASTY INSERTION POST SPINOUS, LUMB, SINGLE INSERION POST SPINOUS, LUMB, ADDITION FNA W/O IMAGE FNA W/IMAGE ACNE SURGERY DRAINAGE OF SKIN ABSCESS DRAINAGE OF SKIN ABSCESS DRAINAGE OF PILONIDAL CYST DRAINAGE OF PILONIDAL CYST REMOVE FOREIGN BODY REMOVE FOREIGN BODY PUNCTURE DRAINAGE OF LESION DEBRIDE TISSUE/MUSCLE DEBRIDE TISSUE/MUSCLE/BONE TRIM SKIN LESION TRIM SKIN LESIONS- 2 TO 4 TRIM SKIN LESIONS- OVER 4

A 08

JAN 08 JAN 08

D 08

Appendix G – CPT Codes for Measures #1 and #2 *Codes with 50 modifier should be excluded as they are bilateral procedures

CPT Code 11100 11101 11200 11201 11300 11301 11302 11303 11305 11306 11307 11308 11310 11311 11312 11313 11400 11401 11402 11403 11404 11406 11420 11421 11422 11423 11424 11426 11440 11441 11442 11443 11444 11446 11450 11451 11462 11463

CPT Description BX SKIN &/ SUBQ TISSUE; 1 LESION BX SKIN &/ SUBQ TISSUE; EA ADD REMOVAL OF SKIN TAGS REMOVE SKIN TAGS ADD-ON SHAVE SKIN LESION SHAVE SKIN LESION SHAVE SKIN LESION SHAVE SKIN LESION SHAVE SKIN LESION SHAVE SKIN LESION SHAVE SKIN LESION SHAVE SKIN LESION SHAVE SKIN LESION SHAVE SKIN LESION SHAVE SKIN LESION SHAVE SKIN LESION EXC TR-EXT B9+MARG 0.5 < CM EXC TR-EXT B9+MARG 0.6-1 CM EXC TR-EXT B9+MARG 1.1-2 CM EXC TR-EXT B9+MARG 2.1-3 CM EXC TR-EXT B9+MARG 3.1-4 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 0.6-1 EXC H-F-NK-SP B9+MARG 1.1-2 EXC H-F-NK-SP B9+MARG 2.1-3 EXC H-F-NK-SP B9+MARG 3.1-4 EXC H-F-NK-SP B9+MARG > 4 CM EXC FACE-MM B9+MARG 0.5 < CM EXC FACE-MM B9+MARG 0.6-1 CM EXC FACE-MM B9+MARG 1.1-2 CM EXC FACE-MM B9+MARG 2.1-3 CM EXC FACE-MM B9+MARG 3.1-4 CM EXC FACE-MM B9+MARG > 4 CM REMOVAL- SWEAT GLAND LESION REMOVAL- SWEAT GLAND LESION REMOVAL- SWEAT GLAND LESION REMOVAL- SWEAT GLAND LESION

A 07

D 07

A 08

D 08

Appendix G – CPT Codes for Measures #1 and #2 *Codes with 50 modifier should be excluded as they are bilateral procedures

CPT Code 11470 11471 11600 11601 11602 11603 11604 11606 11620 11621 11622 11623 11624 11626 11640 11641 11642 11643 11644 11646 11730 11732 11750 11752 11755 11760 11762 11765 11900 11901 11920 11921 11922 11950 11951 11952 11954 11960

CPT Description REMOVAL- SWEAT GLAND LESION REMOVAL- SWEAT GLAND LESION EXC TR-EXT MLG+MARG 0.5 < CM EXC TR-EXT MLG+MARG 0.6-1 CM EXC TR-EXT MLG+MARG 1.1-2 CM EXC TR-EXT MLG+MARG 2.1-3 CM EXC TR-EXT MLG+MARG 3.1-4 CM EXC TR-EXT MLG+MARG > 4 CM EXC H-F-NK-SP MLG+MARG 0.5 < EXC H-F-NK-SP MLG+MARG 0.6-1 EXC H-F-NK-SP MLG+MARG 1.1-2 EXC H-F-NK-SP MLG+MARG 2.1-3 EXC H-F-NK-SP MLG+MARG 3.1-4 EXC H-F-NK-SP MLG+MAR > 4 CM EXC FACE-MM MALIG+MARG 0.5 < EXC FACE-MM MALIG+MARG 0.6-1 EXC FACE-MM MALIG+MARG 1.1-2 EXC FACE-MM MALIG+MARG 2.1-3 EXC FACE-MM MALIG+MARG 3.1-4 EXC FACE-MM MLG+MARG > 4 CM REMOVAL OF NAIL PLATE REMOVE NAIL PLATE- ADD-ON REMOVAL OF NAIL BED REMOVE NAIL BED/FINGER TIP BIOPSY- NAIL UNIT REPAIR OF NAIL BED RECONSTRUCTION OF NAIL BED EXCISION OF NAIL FOLD- TOE INJECTION INTO SKIN LESIONS ADDED SKIN LESIONS INJECTION CORRECT SKIN COLOR DEFECTS CORRECT SKIN COLOR DEFECTS CORRECT SKIN COLOR DEFECTS THERAPY FOR CONTOUR DEFECTS THERAPY FOR CONTOUR DEFECTS THERAPY FOR CONTOUR DEFECTS THERAPY FOR CONTOUR DEFECTS INSERT TISSUE EXPANDER(S)

A 07

D 07

A 08

D 08

Appendix G – CPT Codes for Measures #1 and #2 *Codes with 50 modifier should be excluded as they are bilateral procedures

CPT Code 11970 11971 11976 11982 13100 13101 13102 13120 13121 13122 13131 13132 13133 13150 13151 13152 13153 13160 14000 14001 14020 14021 14040 14041 14060 14061 14300 14350 15000 15001 15050 15100 15101 15120 15121 15200 15201 15220

CPT Description REPLACE TISSUE EXPANDER REMOVE TISSUE EXPANDER(S) REMOVAL OF CONTRACEPTIVE CAP REMOVE DRUG IMPLANT DEVICE REPAIR OF WOUND OR LESION REPAIR OF WOUND OR LESION REPAIR WOUND/LESION ADD-ON REPAIR OF WOUND OR LESION REPAIR OF WOUND OR LESION REPAIR WOUND/LESION ADD-ON REPAIR OF WOUND OR LESION REPAIR OF WOUND OR LESION REPAIR WOUND/LESION ADD-ON REPAIR OF WOUND OR LESION REPAIR OF WOUND OR LESION REPAIR OF WOUND OR LESION REPAIR WOUND/LESION ADD-ON LATE CLOSURE OF WOUND SKIN TISSUE REARRANGEMENT SKIN TISSUE REARRANGEMENT SKIN TISSUE REARRANGEMENT SKIN TISSUE REARRANGEMENT SKIN TISSUE REARRANGEMENT SKIN TISSUE REARRANGEMENT SKIN TISSUE REARRANGEMENT SKIN TISSUE REARRANGEMENT SKIN TISSUE REARRANGEMENT SKIN TISSUE REARRANGEMENT SKIN GRAFT SKIN GRAFT ADD-ON SKIN PINCH GRAFT SKIN SPLIT GRAFT SKIN SPLIT GRAFT ADD-ON SKIN SPLIT GRAFT SKIN SPLIT GRAFT ADD-ON SKIN FULL GRAFT SKIN FULL GRAFT ADD-ON SKIN FULL GRAFT

A 07

D 07

JAN 07 JAN 07

A 08

D 08

Appendix G – CPT Codes for Measures #1 and #2 *Codes with 50 modifier should be excluded as they are bilateral procedures

CPT Code 15221 15240 15241 15260 15261 15342 15343 15350 15351 15400 15401 15570 15572 15574 15576 15600 15610 15620 15630 15650 15732 15734 15736 15738 15740 15750 15756 15757 15758 15760 15775 15776 15781 15782 15783 15819 15820 15821

CPT Description SKIN FULL GRAFT ADD-ON SKIN FULL GRAFT SKIN FULL GRAFT ADD-ON SKIN FULL GRAFT SKIN FULL GRAFT ADD-ON CULTURED SKIN GRAFT- 25 CM CULTURE SKN GRAFT ADDL 25 CM SKIN HOMOGRAFT SKIN HOMOGRAFT ADD-ON SKIN HETEROGRAFT SKIN HETEROGRAFT ADD-ON FORM SKIN PEDICLE FLAP FORM SKIN PEDICLE FLAP FORM SKIN PEDICLE FLAP FORM SKIN PEDICLE FLAP SKIN GRAFT SKIN GRAFT SKIN GRAFT SKIN GRAFT TRANSFER SKIN PEDICLE FLAP MUSCLE-SKIN GRAFT- HEAD/NECK MUSCLE-SKIN GRAFT- TRUNK MUSCLE-SKIN GRAFT- ARM MUSCLE-SKIN GRAFT- LEG ISLAND PEDICLE FLAP GRAFT NEUROVASCULAR PEDICLE GRAFT FREE MYO/SKIN FLAP MICROVASC FREE SKIN FLAP- MICROVASC FREE FASCIAL FLAP- MICROVASC COMPOSITE SKIN GRAFT HAIR TRANSPLANT PUNCH GRAFTS HAIR TRANSPLANT PUNCH GRAFTS ABRASION TREATMENT OF SKIN ABRASION TREATMENT OF SKIN ABRASION TREATMENT OF SKIN PLASTIC SURGERY- NECK REVISION OF LOWER EYELID REVISION OF LOWER EYELID

A 07

D 07

A 08

D 08

Appendix G – CPT Codes for Measures #1 and #2 *Codes with 50 modifier should be excluded as they are bilateral procedures

CPT Code 15822 15823 15824 15825 15826 15828 15829 15831 15832 15833 15834 15835 15836 15837 15838 15839 15840 15841 15842 15845 15860 15876 15877 15878 15879 15920 15922 15931 15933 15934 15935 15936 15937 15940 15941 15944 15945 15946

CPT Description REVISION OF UPPER EYELID REVISION OF UPPER EYELID REMOVAL OF FOREHEAD WRINKLES REMOVAL OF NECK WRINKLES REMOVAL OF BROW WRINKLES REMOVAL OF FACE WRINKLES REMOVAL OF SKIN WRINKLES EXCISE EXCESSIVE SKIN TISSUE EXCISE EXCESSIVE SKIN TISSUE EXCISE EXCESSIVE SKIN TISSUE EXCISE EXCESSIVE SKIN TISSUE EXCISE EXCESSIVE SKIN TISSUE EXCISE EXCESSIVE SKIN TISSUE EXCISE EXCESSIVE SKIN TISSUE EXCISE EXCESSIVE SKIN TISSUE EXCISE EXCESSIVE SKIN TISSUE GRAFT FOR FACE NERVE PALSY GRAFT FOR FACE NERVE PALSY FLAP FOR FACE NERVE PALSY SKIN AND MUSCLE REPAIR- FACE TEST FOR BLOOD FLOW IN GRAFT SUCTION ASSISTED LIPECTOMY SUCTION ASSISTED LIPECTOMY SUCTION ASSISTED LIPECTOMY SUCTION ASSISTED LIPECTOMY REMOVAL OF TAIL BONE ULCER REMOVAL OF TAIL BONE ULCER REMOVE SACRUM PRESSURE SORE REMOVE SACRUM PRESSURE SORE REMOVE SACRUM PRESSURE SORE REMOVE SACRUM PRESSURE SORE REMOVE SACRUM PRESSURE SORE REMOVE SACRUM PRESSURE SORE REMOVE HIP PRESSURE SORE REMOVE HIP PRESSURE SORE REMOVE HIP PRESSURE SORE REMOVE HIP PRESSURE SORE REMOVE HIP PRESSURE SORE

A 07

D 07

JAN 07

A 08

D 08

Appendix G – CPT Codes for Measures #1 and #2 *Codes with 50 modifier should be excluded as they are bilateral procedures

CPT Code 15950 15951 15952 15953 15956 15958 15999 16035 16036 17000 17003 17004 17106 17107 17108 17110 17111 17250 17260 17261 17262 17263 17264 17266 17270 17271 17272 17273 17274 17276 17280 17281 17282 17283 17284 17286 17340 17380

CPT Description REMOVE THIGH PRESSURE SORE REMOVE THIGH PRESSURE SORE REMOVE THIGH PRESSURE SORE REMOVE THIGH PRESSURE SORE REMOVE THIGH PRESSURE SORE REMOVE THIGH PRESSURE SORE REMOVAL OF PRESSURE SORE INCISION OF BURN SCAB- INITI INCISE BURN SCAB- ADDL INCIS DESTROY BENIGN/PREMLG LESION DESTROY LESIONS- 2-14 DESTROY LESIONS- 15 OR MORE DESTRUCTION OF SKIN LESIONS DESTRUCTION OF SKIN LESIONS DESTRUCTION OF SKIN LESIONS DESTRUCT LESION- 1-14 DESTRUCT LESION- 15 OR MORE CHEMICAL CAUTERY- TISSUE DESTRUCTION OF SKIN LESIONS DESTRUCTION OF SKIN LESIONS DESTRUCTION OF SKIN LESIONS DESTRUCTION OF SKIN LESIONS DESTRUCTION OF SKIN LESIONS DESTRUCTION OF SKIN LESIONS DESTRUCTION OF SKIN LESIONS DESTRUCTION OF SKIN LESIONS DESTRUCTION OF SKIN LESIONS DESTRUCTION OF SKIN LESIONS DESTRUCTION OF SKIN LESIONS DESTRUCTION OF SKIN LESIONS DESTRUCTION OF SKIN LESIONS DESTRUCTION OF SKIN LESIONS DESTRUCTION OF SKIN LESIONS DESTRUCTION OF SKIN LESIONS DESTRUCTION OF SKIN LESIONS DESTRUCTION OF SKIN LESIONS CRYOTHERAPY OF SKIN HAIR REMOVAL BY ELECTROLYSIS

A 07

D 07

A 08

D 08

Appendix G – CPT Codes for Measures #1 and #2 *Codes with 50 modifier should be excluded as they are bilateral procedures

CPT Code 17999 19000 19001 19020 19030 19100 19101 19102 19103 19110 19112 19120 19125 19126 19140 19160 19162 19180 19182 19200 19220 19240 19260 19271 19272 19290 19291 19295 19296 19298 19316 19318 19324 19325 19328 19330 19340 19342

CPT Description SKIN TISSUE PROCEDURE DRAINAGE OF BREAST LESION DRAIN BREAST LESION ADD-ON INCISION OF BREAST LESION INJECTION FOR BREAST X-RAY BX BREAST PERCUT W/O IMAGE BIOPSY OF BREAST- OPEN BX BREAST PERCUT W/IMAGE BX BREAST PERCUT W/DEVICE NIPPLE EXPLORATION EXCISE BREAST DUCT FISTULA REMOVAL OF BREAST LESION EXCISION- BREAST LESION EXCISION- ADDL BREAST LESION REMOVAL OF BREAST TISSUE MASTECTOMY PARTIAL; MASTECT PART; AXILLARY LYMPHADENECT REMOVAL OF BREAST REMOVAL OF BREAST REMOVAL OF BREAST REMOVAL OF BREAST REMOVAL OF BREAST REMOVAL OF CHEST WALL LESION REVISION OF CHEST WALL EXTENSIVE CHEST WALL SURGERY PLACE NEEDLE WIRE- BREAST PLACE NEEDLE WIRE- BREAST PLACE BREAST CLIP- PERCUT RT BALLN CATH;DATE SEP PART MASTECT RT BRCHYTX CATH FLW PART MASTECT SUSPENSION OF BREAST REDUCTION OF LARGE BREAST ENLARGE BREAST ENLARGE BREAST WITH IMPLANT REMOVAL OF BREAST IMPLANT REMOVAL OF IMPLANT MATERIAL IMMEDIATE BREAST PROSTHESIS DELAYED BREAST PROSTHESIS

A 07

D 07

JAN 07 JAN 07 JAN 07 JAN 07 JAN 07 JAN 07 JAN 07 JAN 07

A 08

D 08

Appendix G – CPT Codes for Measures #1 and #2 *Codes with 50 modifier should be excluded as they are bilateral procedures

CPT Code 19350 19355 19357 19361 19364 19366 19367 19368 19369 19370 19371 19380 19396 19499 20000 20005 20100 20101 20102 20103 20150 20200 20205 20206 20220 20225 20240 20245 20250 20251 20500 20501 20520 20525 20550 20551 20552 20553

CPT Description BREAST RECONSTRUCTION CORRECT INVERTED NIPPLE(S) BREAST RECONSTRUCTION BREAST RECONSTRUCTION BREAST RECONSTRUCTION BREAST RECONSTRUCTION BREAST RECONSTRUCTION BREAST RECONSTRUCTION BREAST RECONSTRUCTION SURGERY OF BREAST CAPSULE REMOVAL OF BREAST CAPSULE REVISE BREAST RECONSTRUCTION DESIGN CUSTOM BREAST IMPLANT BREAST SURGERY PROCEDURE INCISION OF ABSCESS INCISION OF DEEP ABSCESS EXPLORE WOUND- NECK EXPLORE WOUND- CHEST EXPLORE WOUND- ABDOMEN EXPLORE WOUND- EXTREMITY EXCISE EPIPHYSEAL BAR MUSCLE BIOPSY DEEP MUSCLE BIOPSY NEEDLE BIOPSY- MUSCLE BONE BIOPSY- TROCAR/NEEDLE BONE BIOPSY- TROCAR/NEEDLE BIOPSY BONE OPEN; SUPERFICIAL BIOPSY BONE OPEN; DEEP OPEN BONE BIOPSY OPEN BONE BIOPSY INJECTION OF SINUS TRACT INJECT SINUS TRACT FOR X-RAY REMOVAL OF FOREIGN BODY REMOVAL OF FOREIGN BODY INJECTION; 1 TENDON SHEATH/LIGAMENT INJECTION; 1 TENDON ORIGIN/INSERTIO INJ; SINGLE/MX TRIG POINT 1/2 MUSCL INJECT TRIGGER POINTS- =/> 3

A 07

D 07

A 08

D 08

Appendix G – CPT Codes for Measures #1 and #2 *Codes with 50 modifier should be excluded as they are bilateral procedures

CPT Code 20600 20605 20610 20612 20615 20670 20680 20690 20692 20693 20694 20802 20805 20808 20816 20822 20824 20827 20838 20900 20902 20910 20920 20922 20924 20926 20930 20931 20936 20937 20938 20950 20955 20956 20957 20962 20969 20970

CPT Description DRAIN/INJECT- JOINT/BURSA DRAIN/INJECT- JOINT/BURSA DRAIN/INJECT- JOINT/BURSA ASPIRATE/INJ GANGLION CYST TREATMENT OF BONE CYST REMOVAL OF SUPPORT IMPLANT REMOVAL OF SUPPORT IMPLANT APPLY BONE FIXATION DEVICE APPLY BONE FIXATION DEVICE ADJUST BONE FIXATION DEVICE REMOVE BONE FIXATION DEVICE REPLANTATION- ARM- COMPLETE REPLANT FOREARM- COMPLETE REPLANTATION HAND- COMPLETE REPLANTATION DIGIT- COMPLETE REPLANTATION DIGIT- COMPLETE REPLANTATION THUMB- COMPLETE REPLANTATION THUMB- COMPLETE REPLANTATION FOOT- COMPLETE REMOVAL OF BONE FOR GRAFT REMOVAL OF BONE FOR GRAFT REMOVE CARTILAGE FOR GRAFT REMOVAL OF FASCIA FOR GRAFT REMOVAL OF FASCIA FOR GRAFT REMOVAL OF TENDON FOR GRAFT REMOVAL OF TISSUE FOR GRAFT SPINAL BONE ALLOGRAFT SPINAL BONE ALLOGRAFT SPINAL BONE AUTOGRAFT SPINAL BONE AUTOGRAFT SPINAL BONE AUTOGRAFT FLUID PRESSURE- MUSCLE FIBULA BONE GRAFT- MICROVASC ILIAC BONE GRAFT- MICROVASC MT BONE GRAFT- MICROVASC OTHER BONE GRAFT- MICROVASC BONE/SKIN GRAFT- MICROVASC BONE/SKIN GRAFT- ILIAC CREST

A 07

D 07

A 08

D 08

Appendix G – CPT Codes for Measures #1 and #2 *Codes with 50 modifier should be excluded as they are bilateral procedures

CPT Code 20972 20973 20975 20982 20999 21010 21015 21025 21026 21029 21030 21031 21034 21040 21044 21045 21046 21047 21048 21049 21050 21060 21070 21116 21123 21125 21127 21137 21138 21139 21141 21142 21143 21145 21146 21147 21150 21151

CPT Description BONE/SKIN GRAFT- METATARSAL BONE/SKIN GRAFT- GREAT TOE ELECTRICAL BONE STIMULATION ABLAT BN TUMR RADIOFRQ PERQ CT GUID MUSCULOSKELETAL SURGERY INCISION OF JAW JOINT RESECTION OF FACIAL TUMOR EXCISION OF BONE- LOWER JAW EXCISION OF FACIAL BONE(S) CONTOUR OF FACE BONE LESION EXCISE MAX/ZYGOMA B9 TUMOR REMOVE EXOSTOSIS- MANDIBLE EXCISE MAX/ZYGOMA MLG TUMOR EXCISE MANDIBLE LESION REMOVAL OF JAW BONE LESION EXTENSIVE JAW SURGERY REMOVE MANDIBLE CYST COMPLEX EXCISE LWR JAW CYST W/REPAIR REMOVE MAXILLA CYST COMPLEX EXCIS UPPR JAW CYST W/REPAIR REMOVAL OF JAW JOINT REMOVE JAW JOINT CARTILAGE REMOVE CORONOID PROCESS INJECTION- JAW JOINT X-RAY RECONSTRUCTION OF CHIN AUGMENTATION- LOWER JAW BONE AUGMENTATION- LOWER JAW BONE REDUCTION OF FOREHEAD REDUCTION OF FOREHEAD REDUCTION OF FOREHEAD RECONSTRUCT MIDFACE- LEFORT RECONSTRUCT MIDFACE- LEFORT RECONSTRUCT MIDFACE- LEFORT RECONSTRUCT MIDFACE- LEFORT RECONSTRUCT MIDFACE- LEFORT RECONSTRUCT MIDFACE- LEFORT RECONSTRUCT MIDFACE- LEFORT RECONSTRUCT MIDFACE- LEFORT

A 07

D 07

A 08

D 08

Appendix G – CPT Codes for Measures #1 and #2 *Codes with 50 modifier should be excluded as they are bilateral procedures

CPT Code 21154 21155 21159 21160 21172 21175 21179 21180 21181 21182 21183 21184 21188 21194 21208 21210 21215 21230 21235 21240 21242 21243 21244 21245 21246 21247 21248 21249 21255 21256 21260 21261 21263 21267 21268 21270 21275 21280

CPT Description RECONSTRUCT MIDFACE- LEFORT RECONSTRUCT MIDFACE- LEFORT RECONSTRUCT MIDFACE- LEFORT RECONSTRUCT MIDFACE- LEFORT RECONSTRUCT ORBIT/FOREHEAD RECONSTRUCT ORBIT/FOREHEAD RECONSTRUCT ENTIRE FOREHEAD RECONSTRUCT ENTIRE FOREHEAD CONTOUR CRANIAL BONE LESION RECONSTRUCT CRANIAL BONE RECONSTRUCT CRANIAL BONE RECONSTRUCT CRANIAL BONE RECONSTRUCTION OF MIDFACE RECONST LWR JAW W/GRAFT AUGMENTATION OF FACIAL BONES FACE BONE GRAFT LOWER JAW BONE GRAFT RIB CARTILAGE GRAFT EAR CARTILAGE GRAFT RECONSTRUCTION OF JAW JOINT RECONSTRUCTION OF JAW JOINT RECONSTRUCTION OF JAW JOINT RECONSTRUCTION OF LOWER JAW RECONSTRUCTION OF JAW RECONSTRUCTION OF JAW RECONSTRUCT LOWER JAW BONE RECONSTRUCTION OF JAW RECONSTRUCTION OF JAW RECONSTRUCT LOWER JAW BONE RECONSTRUCTION OF ORBIT REVISE EYE SOCKETS REVISE EYE SOCKETS REVISE EYE SOCKETS REVISE EYE SOCKETS REVISE EYE SOCKETS AUGMENTATION- CHEEK BONE REVISION- ORBITOFACIAL BONES REVISION OF EYELID

A 07

D 07

A 08

D 08

Appendix G – CPT Codes for Measures #1 and #2 *Codes with 50 modifier should be excluded as they are bilateral procedures

CPT Code 21282 21295 21296 21299 21300 21345 21346 21347 21348 21355 21356 21360 21365 21366 21385 21386 21387 21390 21395 21401 21406 21407 21408 21421 21422 21423 21431 21432 21433 21435 21436 21440 21445 21451 21452 21453 21454 21461

CPT Description REVISION OF EYELID REVISION OF JAW MUSCLE/BONE REVISION OF JAW MUSCLE/BONE CRANIO/MAXILLOFACIAL SURGERY TREATMENT OF SKULL FRACTURE TREAT NOSE/JAW FRACTURE TREAT NOSE/JAW FRACTURE TREAT NOSE/JAW FRACTURE TREAT NOSE/JAW FRACTURE TREAT CHEEK BONE FRACTURE TREAT CHEEK BONE FRACTURE TREAT CHEEK BONE FRACTURE TREAT CHEEK BONE FRACTURE TREAT CHEEK BONE FRACTURE TREAT EYE SOCKET FRACTURE TREAT EYE SOCKET FRACTURE TREAT EYE SOCKET FRACTURE TREAT EYE SOCKET FRACTURE TREAT EYE SOCKET FRACTURE TREAT EYE SOCKET FRACTURE TREAT EYE SOCKET FRACTURE TREAT EYE SOCKET FRACTURE TREAT EYE SOCKET FRACTURE TREAT MOUTH ROOF FRACTURE TREAT MOUTH ROOF FRACTURE TREAT MOUTH ROOF FRACTURE TREAT CRANIOFACIAL FRACTURE TREAT CRANIOFACIAL FRACTURE TREAT CRANIOFACIAL FRACTURE TREAT CRANIOFACIAL FRACTURE TREAT CRANIOFACIAL FRACTURE TREAT DENTAL RIDGE FRACTURE TREAT DENTAL RIDGE FRACTURE TREAT LOWER JAW FRACTURE TREAT LOWER JAW FRACTURE TREAT LOWER JAW FRACTURE TREAT LOWER JAW FRACTURE TREAT LOWER JAW FRACTURE

A 07

D 07

JAN 07

A 08

D 08

Appendix G – CPT Codes for Measures #1 and #2 *Codes with 50 modifier should be excluded as they are bilateral procedures

CPT Code 21462 21465 21470 21480 21485 21490 21493 21494 21495 21499 21501 21502 21510 21550 21555 21556 21557 21600 21610 21615 21616 21620 21627 21630 21632 21700 21705 21720 21725 21740 21742 21743 21750 21805 21810 21825 21899 21920

CPT Description TREAT LOWER JAW FRACTURE TREAT LOWER JAW FRACTURE TREAT LOWER JAW FRACTURE RESET DISLOCATED JAW RESET DISLOCATED JAW REPAIR DISLOCATED JAW TREAT HYOID BONE FRACTURE TREAT HYOID BONE FRACTURE TREAT HYOID BONE FRACTURE HEAD SURGERY PROCEDURE DRAIN NECK/CHEST LESION DRAIN CHEST LESION DRAINAGE OF BONE LESION BIOPSY OF NECK/CHEST REMOVE LESION- NECK/CHEST REMOVE LESION- NECK/CHEST REMOVE TUMOR- NECK/CHEST PARTIAL REMOVAL OF RIB PARTIAL REMOVAL OF RIB REMOVAL OF RIB REMOVAL OF RIB AND NERVES PARTIAL REMOVAL OF STERNUM STERNAL DEBRIDEMENT EXTENSIVE STERNUM SURGERY EXTENSIVE STERNUM SURGERY REVISION OF NECK MUSCLE REVISION OF NECK MUSCLE/RIB REVISION OF NECK MUSCLE REVISION OF NECK MUSCLE RECONSTRUCTION OF STERNUM REPAIR STERN/NUSS W/O SCOPE REPAIR STERNUM/NUSS W/SCOPE REPAIR OF STERNUM SEPARATION TREATMENT OF RIB FRACTURE TREATMENT OF RIB FRACTURE(S) TREAT STERNUM FRACTURE NECK/CHEST SURGERY PROCEDURE BIOPSY SOFT TISSUE OF BACK

A 07

D 07

A 08

D 08

Appendix G – CPT Codes for Measures #1 and #2 *Codes with 50 modifier should be excluded as they are bilateral procedures

CPT Code 21925 21930 21935 22100 22101 22102 22103 22110 22112 22114 22116 22206 22207 22208 22210 22212 22214 22216 22220 22222 22224 22226 22520 22521 22522 22532 22533 22534 22548 22554 22556 22558 22585 22590 22595 22600 22610 22612

CPT Description BIOPSY SOFT TISSUE OF BACK REMOVE LESION- BACK OR FLANK REMOVE TUMOR- BACK REMOVE PART OF NECK VERTEBRA REMOVE PART- THORAX VERTEBRA REMOVE PART- LUMBAR VERTEBRA REMOVE EXTRA SPINE SEGMENT REMOVE PART OF NECK VERTEBRA REMOVE PART- THORAX VERTEBRA REMOVE PART- LUMBAR VERTEBRA REMOVE EXTRA SPINE SEGMENT OSTEOTOMY SPINE, POST/POSTLAT, THORA OSTEOTOMY SPINE, POST/POSTLAT, LUMB OSTEOTOMY SPINE, EACH ADDL VERT SEG REVISION OF NECK SPINE REVISION OF THORAX SPINE REVISION OF LUMBAR SPINE REVISE- EXTRA SPINE SEGMENT REVISION OF NECK SPINE REVISION OF THORAX SPINE REVISION OF LUMBAR SPINE REVISE- EXTRA SPINE SEGMENT PERCUT VERTEBROPLASTY THOR PERCUT VERTEBROPLASTY LUMB PERCUT VERTEBROPLASTY ADDL ARTHRDSIS LAT MINI DISKECT; THOR ARTHRDSIS LAT MINI DISKECT; LUMB ARTHRDSIS LAT MINI DISKECT; EA ADD NECK SPINE FUSION NECK SPINE FUSION THORAX SPINE FUSION LUMBAR SPINE FUSION ADDITIONAL SPINAL FUSION SPINE & SKULL SPINAL FUSION NECK SPINAL FUSION NECK SPINE FUSION THORAX SPINE FUSION LUMBAR SPINE FUSION

A 07

D 07

A 08

JAN 08 JAN 08 JAN 08

D 08

Appendix G – CPT Codes for Measures #1 and #2 *Codes with 50 modifier should be excluded as they are bilateral procedures

CPT Code 22614 22630 22632 22800 22802 22804 22808 22810 22812 22818 22819 22841 22849 22850 22851 22852 22855 22899 22900 23000 23020 23030 23031 23035 23040 23044 23065 23066 23075 23076 23077 23100 23101 23105 23106 23107 23120 23125

CPT Description SPINE FUSION- EXTRA SEGMENT LUMBAR SPINE FUSION SPINE FUSION- EXTRA SEGMENT FUSION OF SPINE FUSION OF SPINE FUSION OF SPINE FUSION OF SPINE FUSION OF SPINE FUSION OF SPINE KYPHECTOMY- 1-2 SEGMENTS KYPHECTOMY- 3 OR MORE INSERT SPINE FIXATION DEVICE REINSERT SPINAL FIXATION REMOVE SPINE FIXATION DEVICE APPLY SPINE PROSTH DEVICE REMOVE SPINE FIXATION DEVICE REMOVE SPINE FIXATION DEVICE SPINE SURGERY PROCEDURE REMOVE ABDOMINAL WALL LESION REMOVAL OF CALCIUM DEPOSITS RELEASE SHOULDER JOINT DRAIN SHOULDER LESION DRAIN SHOULDER BURSA DRAIN SHOULDER BONE LESION EXPLORATORY SHOULDER SURGERY EXPLORATORY SHOULDER SURGERY BIOPSY SHOULDER TISSUES BIOPSY SHOULDER TISSUES REMOVAL OF SHOULDER LESION REMOVAL OF SHOULDER LESION REMOVE TUMOR OF SHOULDER BIOPSY OF SHOULDER JOINT SHOULDER JOINT SURGERY REMOVE SHOULDER JOINT LINING INCISION OF COLLARBONE JOINT EXPLORE TREAT SHOULDER JOINT PARTIAL REMOVAL- COLLAR BONE REMOVAL OF COLLAR BONE

A 07

D 07

A 08

D 08

Appendix G – CPT Codes for Measures #1 and #2 *Codes with 50 modifier should be excluded as they are bilateral procedures

CPT Code 23130 23140 23145 23146 23150 23155 23156 23170 23172 23174 23180 23182 23184 23190 23195 23200 23210 23220 23221 23222 23330 23331 23332 23395 23397 23400 23405 23406 23410 23412 23415 23420 23430 23440 23450 23455 23460 23462

CPT Description REMOVE SHOULDER BONE- PART REMOVAL OF BONE LESION REMOVAL OF BONE LESION REMOVAL OF BONE LESION REMOVAL OF HUMERUS LESION REMOVAL OF HUMERUS LESION REMOVAL OF HUMERUS LESION REMOVE COLLAR BONE LESION REMOVE SHOULDER BLADE LESION REMOVE HUMERUS LESION REMOVE COLLAR BONE LESION REMOVE SHOULDER BLADE LESION REMOVE HUMERUS LESION PARTIAL REMOVAL OF SCAPULA REMOVAL OF HEAD OF HUMERUS REMOVAL OF COLLAR BONE REMOVAL OF SHOULDER BLADE PARTIAL REMOVAL OF HUMERUS PARTIAL REMOVAL OF HUMERUS PARTIAL REMOVAL OF HUMERUS REMOVE SHOULDER FOREIGN BODY REMOVE SHOULDER FOREIGN BODY REMOVE SHOULDER FOREIGN BODY MUSCLE TRANSFER-SHOULDER/ARM MUSCLE TRANSFERS FIXATION OF SHOULDER BLADE INCISION OF TENDON & MUSCLE INCISE TENDON(S) & MUSCLE(S) OP REP AC RC OR M/C RUPT OP REP CHR RC/M/T RUPT RELEASE OF SHOULDER LIGAMENT RECONST COMP RC AVUL REPAIR BICEPS TENDON REMOVE/TRANSPLANT TENDON REPAIR SHOULDER CAPSULE REPAIR SHOULDER CAPSULE REPAIR SHOULDER CAPSULE REPAIR SHOULDER CAPSULE

A 07

D 07

OCT 06 OCT 06 OCT 06

A 08

D 08

Appendix G – CPT Codes for Measures #1 and #2 *Codes with 50 modifier should be excluded as they are bilateral procedures

CPT Code 23465 23466 23470 23472 23480 23485 23490 23491 23515 23530 23532 23550 23552 23585 23615 23616 23630 23660 23670 23680 23700 23800 23802 23900 23920 23921 23929 23930 23931 23935 24000 24006 24065 24066 24075 24076 24077 24100

CPT Description REPAIR SHOULDER CAPSULE REPAIR SHOULDER CAPSULE RECONSTRUCT SHOULDER JOINT RECONSTRUCT SHOULDER JOINT REVISION OF COLLAR BONE REVISION OF COLLAR BONE REINFORCE CLAVICLE REINFORCE SHOULDER BONES TREAT CLAVICLE FRACTURE TREAT CLAVICLE DISLOCATION TREAT CLAVICLE DISLOCATION TREAT CLAVICLE DISLOCATION TREAT CLAVICLE DISLOCATION TREAT SCAPULA FRACTURE TREAT HUMERUS FRACTURE TREAT HUMERUS FRACTURE TREAT HUMERUS FRACTURE TREAT SHOULDER DISLOCATION TREAT DISLOCATION/FRACTURE TREAT DISLOCATION/FRACTURE FIXATION OF SHOULDER FUSION OF SHOULDER JOINT FUSION OF SHOULDER JOINT AMPUTATION OF ARM & GIRDLE AMPUTATION AT SHOULDER JOINT AMPUTATION FOLLOW-UP SURGERY SHOULDER SURGERY PROCEDURE DRAINAGE OF ARM LESION DRAINAGE OF ARM BURSA DRAIN ARM/ELBOW BONE LESION EXPLORATORY ELBOW SURGERY RELEASE ELBOW JOINT BIOPSY ARM/ELBOW SOFT TISSUE BIOPSY ARM/ELBOW SOFT TISSUE REMOVE ARM/ELBOW LESION REMOVE ARM/ELBOW LESION REMOVE TUMOR OF ARM/ELBOW BIOPSY ELBOW JOINT LINING

A 07

D 07

A 08

D 08

Appendix G – CPT Codes for Measures #1 and #2 *Codes with 50 modifier should be excluded as they are bilateral procedures

CPT Code 24101 24102 24105 24110 24115 24116 24120 24125 24126 24130 24134 24136 24138 24140 24145 24147 24149 24150 24151 24152 24153 24155 24160 24164 24200 24201 24301 24305 24310 24320 24330 24331 24332 24340 24341 24342 24343 24344

CPT Description EXPLORE/TREAT ELBOW JOINT REMOVE ELBOW JOINT LINING REMOVAL OF ELBOW BURSA REMOVE HUMERUS LESION REMOVE/GRAFT BONE LESION REMOVE/GRAFT BONE LESION REMOVE ELBOW LESION REMOVE/GRAFT BONE LESION REMOVE/GRAFT BONE LESION REMOVAL OF HEAD OF RADIUS REMOVAL OF ARM BONE LESION REMOVE RADIUS BONE LESION REMOVE ELBOW BONE LESION PARTIAL REMOVAL OF ARM BONE PARTIAL REMOVAL OF RADIUS PARTIAL REMOVAL OF ELBOW RADICAL RESECTION OF ELBOW EXTENSIVE HUMERUS SURGERY EXTENSIVE HUMERUS SURGERY EXTENSIVE RADIUS SURGERY EXTENSIVE RADIUS SURGERY REMOVAL OF ELBOW JOINT REMOVE ELBOW JOINT IMPLANT REMOVE RADIUS HEAD IMPLANT REMOVAL OF ARM FOREIGN BODY REMOVAL OF ARM FOREIGN BODY MUSCLE/TENDON TRANSFER ARM TENDON LENGTHENING REVISION OF ARM TENDON REPAIR OF ARM TENDON REVISION OF ARM MUSCLES REVISION OF ARM MUSCLES TENOLYSIS- TRICEPS REPAIR OF BICEPS TENDON REPAIR ARM TENDON/MUSCLE REPAIR OF RUPTURED TENDON REPR ELBOW LAT LIGMNT W/TISS RECONSTRUCT ELBOW LAT LIGMNT

A 07

D 07

A 08

D 08

Appendix G – CPT Codes for Measures #1 and #2 *Codes with 50 modifier should be excluded as they are bilateral procedures

CPT Code 24345 24346 24350 24351 24352 24354 24356 24357 24358 24359 24360 24361 24362 24363 24365 24366 24400 24410 24420 24430 24435 24470 24495 24498 24515 24516 24545 24546 24575 24579 24586 24587 24615 24635 24665 24666 24685 24800

CPT Description REPR ELBW MED LIGMNT W/TISSU RECONSTRUCT ELBOW MED LIGMNT REPAIR OF TENNIS ELBOW REPAIR OF TENNIS ELBOW REPAIR OF TENNIS ELBOW REPAIR OF TENNIS ELBOW REVISION OF TENNIS ELBOW TENOTOMY, ELBOW, LAT/MED, PERCUTAN TENOTOMY, ELBOW, LAT/MED, DEBRI, OPEN TENOTOMY, ELDBOW, LAT/MED, TENDN REP RECONSTRUCT ELBOW JOINT RECONSTRUCT ELBOW JOINT RECONSTRUCT ELBOW JOINT REPLACE ELBOW JOINT RECONSTRUCT HEAD OF RADIUS RECONSTRUCT HEAD OF RADIUS REVISION OF HUMERUS REVISION OF HUMERUS REVISION OF HUMERUS REPAIR OF HUMERUS REPAIR HUMERUS WITH GRAFT REVISION OF ELBOW JOINT DECOMPRESSION OF FOREARM REINFORCE HUMERUS TREAT HUMERUS FRACTURE TREAT HUMERUS FRACTURE TREAT HUMERUS FRACTURE TREAT HUMERUS FRACTURE TREAT HUMERUS FRACTURE TREAT HUMERUS FRACTURE TREAT ELBOW FRACTURE TREAT ELBOW FRACTURE TREAT ELBOW DISLOCATION TREAT ELBOW FRACTURE TREAT RADIUS FRACTURE TREAT RADIUS FRACTURE TREAT ULNAR FRACTURE FUSION OF ELBOW JOINT

A 07

D 07

A 08

D 08

JAN 08 JAN 08 JAN 08 JAN 08 JAN 08 JAN 08 JAN 08 JAN 08

Appendix G – CPT Codes for Measures #1 and #2 *Codes with 50 modifier should be excluded as they are bilateral procedures

CPT Code 24802 24900 24920 24925 24930 24931 24935 24940 24999 25020 25023 25028 25031 25035 25040 25065 25066 25075 25076 25077 25085 25100 25101 25105 25107 25110 25115 25116 25119 25120 25125 25126 25130 25135 25136 25145 25150 25151

CPT Description FUSION/GRAFT OF ELBOW JOINT AMPUTATION OF UPPER ARM AMPUTATION OF UPPER ARM AMPUTATION FOLLOW-UP SURGERY AMPUTATION FOLLOW-UP SURGERY AMPUTATE UPPER ARM & IMPLANT REVISION OF AMPUTATION REVISION OF UPPER ARM UPPER ARM/ELBOW SURGERY DECOMPRESS FOREARM 1 SPACE DECOMPRESS FOREARM 1 SPACE DRAINAGE OF FOREARM LESION DRAINAGE OF FOREARM BURSA TREAT FOREARM BONE LESION EXPLORE/TREAT WRIST JOINT BIOPSY FOREARM SOFT TISSUES BIOPSY FOREARM SOFT TISSUES REMOVEL FOREARM LESION SUBCU REMOVEL FOREARM LESION DEEP REMOVE TUMOR- FOREARM/WRIST INCISION OF WRIST CAPSULE BIOPSY OF WRIST JOINT EXPLORE/TREAT WRIST JOINT REMOVE WRIST JOINT LINING REMOVE WRIST JOINT CARTILAGE REMOVE WRIST TENDON LESION REMOVE WRIST/FOREARM LESION REMOVE WRIST/FOREARM LESION PARTIAL REMOVAL OF ULNA REMOVAL OF FOREARM LESION REMOVE/GRAFT FOREARM LESION REMOVE/GRAFT FOREARM LESION REMOVAL OF WRIST LESION REMOVE & GRAFT WRIST LESION REMOVE & GRAFT WRIST LESION REMOVE FOREARM BONE LESION PARTIAL REMOVAL OF ULNA PARTIAL REMOVAL OF RADIUS

A 07

D 07

A 08

D 08

Appendix G – CPT Codes for Measures #1 and #2 *Codes with 50 modifier should be excluded as they are bilateral procedures

CPT Code 25170 25210 25215 25230 25240 25248 25250 25251 25263 25265 25272 25274 25275 25280 25290 25295 25310 25312 25315 25316 25320 25332 25335 25337 25350 25355 25360 25365 25370 25375 25390 25391 25392 25393 25394 25400 25405 25415

CPT Description EXTENSIVE FOREARM SURGERY REMOVAL OF WRIST BONE REMOVAL OF WRIST BONES PARTIAL REMOVAL OF RADIUS PARTIAL REMOVAL OF ULNA REMOVE FOREARM FOREIGN BODY REMOVAL OF WRIST PROSTHESIS REMOVAL OF WRIST PROSTHESIS REPAIR FOREARM TENDON/MUSCLE REPAIR FOREARM TENDON/MUSCLE REPAIR FOREARM TENDON/MUSCLE REPAIR FOREARM TENDON/MUSCLE REPAIR FOREARM TENDON SHEATH REVISE WRIST/FOREARM TENDON INCISE WRIST/FOREARM TENDON RELEASE WRIST/FOREARM TENDON TRANSPLANT FOREARM TENDON TRANSPLANT FOREARM TENDON REVISE PALSY HAND TENDON(S) REVISE PALSY HAND TENDON(S) REPAIR/REVISE WRIST JOINT REVISE WRIST JOINT REALIGNMENT OF HAND RECONSTRUCT ULNA/RADIOULNAR REVISION OF RADIUS REVISION OF RADIUS REVISION OF ULNA REVISE RADIUS & ULNA REVISE RADIUS OR ULNA REVISE RADIUS & ULNA SHORTEN RADIUS OR ULNA LENGTHEN RADIUS OR ULNA SHORTEN RADIUS & ULNA LENGTHEN RADIUS & ULNA REPAIR CARPAL BONE- SHORTEN REPAIR RADIUS OR ULNA REPAIR/GRAFT RADIUS OR ULNA REPAIR RADIUS & ULNA

A 07

D 07

A 08

D 08

Appendix G – CPT Codes for Measures #1 and #2 *Codes with 50 modifier should be excluded as they are bilateral procedures

CPT Code 25420 25425 25426 25430 25431 25440 25441 25442 25443 25444 25445 25446 25447 25450 25455 25490 25491 25492 25515 25525 25526 25545 25574 25575 25605 25611 25620 25628 25645 25652 25670 25676 25685 25695 25800 25805 25810 25820

CPT Description REPAIR/GRAFT RADIUS & ULNA REPAIR/GRAFT RADIUS OR ULNA REPAIR/GRAFT RADIUS & ULNA VASC GRAFT INTO CARPAL BONE REPAIR NONUNION CARPAL BONE REPAIR/GRAFT WRIST BONE RECONSTRUCT WRIST JOINT RECONSTRUCT WRIST JOINT RECONSTRUCT WRIST JOINT RECONSTRUCT WRIST JOINT RECONSTRUCT WRIST JOINT WRIST REPLACEMENT REPAIR WRIST JOINT(S) REVISION OF WRIST JOINT REVISION OF WRIST JOINT REINFORCE RADIUS REINFORCE ULNA REINFORCE RADIUS AND ULNA TREAT FRACTURE OF RADIUS TREAT FRACTURE OF RADIUS TREAT FRACTURE OF RADIUS TREAT FRACTURE OF ULNA TREAT FRACTURE RADIUS & ULNA TREAT FRACTURE RADIUS/ULNA TREAT FRACTURE RADIUS/ULNA TREAT FRACTURE RADIUS/ULNA TREAT FRACTURE RADIUS/ULNA TREAT WRIST BONE FRACTURE TREAT WRIST BONE FRACTURE TREAT FRACTURE ULNAR STYLOID TREAT WRIST DISLOCATION TREAT WRIST DISLOCATION TREAT WRIST FRACTURE TREAT WRIST DISLOCATION FUSION OF WRIST JOINT FUSION/GRAFT OF WRIST JOINT FUSION/GRAFT OF WRIST JOINT FUSION OF HAND BONES

A 07

D 07

JAN 07 JAN 07

A 08

D 08

Appendix G – CPT Codes for Measures #1 and #2 *Codes with 50 modifier should be excluded as they are bilateral procedures

CPT Code 25825 25830 25900 25905 25907 25909 25915 25920 25922 25924 25927 25929 25931 25999 26034 26070 26075 26080 26100 26105 26110 26115 26130 26135 26140 26160 26185 26200 26205 26210 26215 26230 26235 26236 26250 26255 26260 26261

CPT Description FUSE HAND BONES WITH GRAFT FUSION- RADIOULNAR JNT/ULNA AMPUTATION OF FOREARM AMPUTATION OF FOREARM AMPUTATION FOLLOW-UP SURGERY AMPUTATION FOLLOW-UP SURGERY AMPUTATION OF FOREARM AMPUTATE HAND AT WRIST AMPUTATE HAND AT WRIST AMPUTATION FOLLOW-UP SURGERY AMPUTATION OF HAND AMPUTATION FOLLOW-UP SURGERY AMPUTATION FOLLOW-UP SURGERY FOREARM OR WRIST SURGERY TREAT HAND BONE LESION EXPLORE/TREAT HAND JOINT EXPLORE/TREAT FINGER JOINT EXPLORE/TREAT FINGER JOINT BIOPSY HAND JOINT LINING BIOPSY FINGER JOINT LINING BIOPSY FINGER JOINT LINING REMOVEL HAND LESION SUBCUT REMOVE WRIST JOINT LINING REVISE FINGER JOINT- EACH REVISE FINGER JOINT- EACH REMOVE TENDON SHEATH LESION REMOVE FINGER BONE REMOVE HAND BONE LESION REMOVE/GRAFT BONE LESION REMOVAL OF FINGER LESION REMOVE/GRAFT FINGER LESION PARTIAL REMOVAL OF HAND BONE PARTIAL REMOVAL- FINGER BONE PARTIAL REMOVAL- FINGER BONE EXTENSIVE HAND SURGERY EXTENSIVE HAND SURGERY EXTENSIVE FINGER SURGERY EXTENSIVE FINGER SURGERY

A 07

D 07

A 08

D 08

Appendix G – CPT Codes for Measures #1 and #2 *Codes with 50 modifier should be excluded as they are bilateral procedures

CPT Code 26262 26320 26499 26516 26517 26518 26520 26525 26530 26531 26535 26536 26540 26541 26542 26545 26546 26548 26556 26560 26561 26562 26565 26567 26568 26580 26587 26607 26615 26665 26685 26686 26715 26735 26746 26765 26785 26820

CPT Description PARTIAL REMOVAL OF FINGER REMOVAL OF IMPLANT FROM HAND REVISION OF FINGER FUSION OF KNUCKLE JOINT FUSION OF KNUCKLE JOINTS FUSION OF KNUCKLE JOINTS RELEASE KNUCKLE CONTRACTURE RELEASE FINGER CONTRACTURE REVISE KNUCKLE JOINT REVISE KNUCKLE WITH IMPLANT REVISE FINGER JOINT REVISE/IMPLANT FINGER JOINT REPAIR HAND JOINT REPAIR HAND JOINT WITH GRAFT REPAIR HAND JOINT WITH GRAFT RECONSTRUCT FINGER JOINT REPAIR NONUNION HAND RECONSTRUCT FINGER JOINT TOE JOINT TRANSFER REPAIR OF WEB FINGER REPAIR OF WEB FINGER REPAIR OF WEB FINGER CORRECT METACARPAL FLAW CORRECT FINGER DEFORMITY LENGTHEN METACARPAL/FINGER REPAIR HAND DEFORMITY RECONSTRUCT EXTRA FINGER TREAT METACARPAL FRACTURE TREAT METACARPAL FRACTURE TREAT THUMB FRACTURE TREAT HAND DISLOCATION TREAT HAND DISLOCATION TREAT KNUCKLE DISLOCATION TREAT FINGER FRACTURE- EACH TREAT FINGER FRACTURE- EACH TREAT FINGER FRACTURE- EACH TREAT FINGER DISLOCATION THUMB FUSION WITH GRAFT

A 07

D 07

A 08

D 08

Appendix G – CPT Codes for Measures #1 and #2 *Codes with 50 modifier should be excluded as they are bilateral procedures

CPT Code 26841 26842 26843 26844 26850 26852 26860 26861 26862 26863 26910 26951 26952 26989 26990 26991 26992 27000 27001 27003 27005 27006 27025 27030 27033 27035 27036 27040 27041 27047 27048 27049 27050 27052 27054 27060 27062 27065

CPT Description FUSION OF THUMB THUMB FUSION WITH GRAFT FUSION OF HAND JOINT FUSION/GRAFT OF HAND JOINT FUSION OF KNUCKLE FUSION OF KNUCKLE WITH GRAFT FUSION OF FINGER JOINT FUSION OF FINGER JNT- ADD-ON FUSION/GRAFT OF FINGER JOINT FUSE/GRAFT ADDED JOINT AMPUTATE METACARPAL BONE AMPUTATION OF FINGER/THUMB AMPUTATION OF FINGER/THUMB HAND/FINGER SURGERY DRAINAGE OF PELVIS LESION DRAINAGE OF PELVIS BURSA DRAINAGE OF BONE LESION INCISION OF HIP TENDON INCISION OF HIP TENDON INCISION OF HIP TENDON INCISION OF HIP TENDON INCISION OF HIP TENDONS INCISION OF HIP/THIGH FASCIA DRAINAGE OF HIP JOINT EXPLORATION OF HIP JOINT DENERVATION OF HIP JOINT EXCISION OF HIP JOINT/MUSCLE BIOPSY OF SOFT TISSUES BIOPSY OF SOFT TISSUES REMOVE HIP/PELVIS LESION REMOVE HIP/PELVIS LESION REMOVE TUMOR- HIP/PELVIS BIOPSY OF SACROILIAC JOINT BIOPSY OF HIP JOINT REMOVAL OF HIP JOINT LINING REMOVAL OF ISCHIAL BURSA REMOVE FEMUR LESION/BURSA REMOVAL OF HIP BONE LESION

A 07

D 07

A 08

D 08

Appendix G – CPT Codes for Measures #1 and #2 *Codes with 50 modifier should be excluded as they are bilateral procedures

CPT Code 27066 27067 27070 27071 27077 27078 27079 27080 27086 27087 27090 27091 27096 27097 27098 27100 27105 27110 27111 27120 27122 27125 27130 27132 27134 27137 27138 27140 27146 27147 27151 27156 27158 27161 27165 27170 27176 27177

CPT Description REMOVAL OF HIP BONE LESION REMOVE/GRAFT HIP BONE LESION PARTIAL REMOVAL OF HIP BONE PARTIAL REMOVAL OF HIP BONE EXTENSIVE HIP SURGERY EXTENSIVE HIP SURGERY EXTENSIVE HIP SURGERY REMOVAL OF TAIL BONE REMOVE HIP FOREIGN BODY REMOVE HIP FOREIGN BODY REMOVAL OF HIP PROSTHESIS REMOVAL OF HIP PROSTHESIS INJECT SACROILIAC JOINT REVISION OF HIP TENDON TRANSFER TENDON TO PELVIS TRANSFER OF ABDOMINAL MUSCLE TRANSFER OF SPINAL MUSCLE TRANSFER OF ILIOPSOAS MUSCLE TRANSFER OF ILIOPSOAS MUSCLE RECONSTRUCTION OF HIP SOCKET RECONSTRUCTION OF HIP SOCKET PARTIAL HIP REPLACEMENT TOTAL HIP ARTHROPLASTY CONVERSION TO TOTAL HIP REVISE HIP JOINT REPLACEMENT REVISE HIP JOINT REPLACEMENT REVISE HIP JOINT REPLACEMENT TRANSPLANT FEMUR RIDGE INCISION OF HIP BONE REVISION OF HIP BONE INCISION OF HIP BONES REVISION OF HIP BONES REVISION OF PELVIS INCISION OF NECK OF FEMUR INCISION/FIXATION OF FEMUR REPAIR/GRAFT FEMUR HEAD/NECK TREAT SLIPPED EPIPHYSIS TREAT SLIPPED EPIPHYSIS

A 07

D 07

OCT 06 OCT 06

A 08

D 08

Appendix G – CPT Codes for Measures #1 and #2 *Codes with 50 modifier should be excluded as they are bilateral procedures

CPT Code 27178 27179 27181 27185 27187 27202 27215 27217 27218 27226 27227 27228 27236 27244 27245 27248 27253 27254 27258 27259 27266 27267 27268 27269 27280 27282 27284 27286 27290 27295 27299 27301 27303 27305 27306 27307 27310 27315

A 07 CPT Description D 07 TREAT SLIPPED EPIPHYSIS REVISE HEAD/NECK OF FEMUR TREAT SLIPPED EPIPHYSIS REVISION OF FEMUR EPIPHYSIS REINFORCE HIP BONES TREAT TAIL BONE FRACTURE TREAT PELVIC FRACTURE(S) TREAT PELVIC RING FRACTURE TREAT PELVIC RING FRACTURE TREAT HIP WALL FRACTURE TREAT HIP FRACTURE(S) TREAT HIP FRACTURE(S) TREAT THIGH FRACTURE TREAT THIGH FRACTURE TREAT THIGH FRACTURE TREAT THIGH FRACTURE TREAT HIP DISLOCATION TREAT HIP DISLOCATION TREAT HIP DISLOCATION TREAT HIP DISLOCATION TREAT HIP DISLOCATION CLOSD TX FEM FX, PROX END, W/OUT MANIP CLOSD TX FEM FX, PROX HEAD W/ MANIP OPEN TX FEM FX, PROX HEAD, INT FIX FUSION OF SACROILIAC JOINT FUSION OF PUBIC BONES FUSION OF HIP JOINT FUSION OF HIP JOINT AMPUTATION OF LEG AT HIP AMPUTATION OF LEG AT HIP OCT 06 PELVIS/HIP JOINT SURGERY DRAIN THIGH/KNEE LESION DRAINAGE OF BONE LESION INCISE THIGH TENDON & FASCIA INCISION OF THIGH TENDON INCISION OF THIGH TENDONS EXPLORATION OF KNEE JOINT PARTIAL REMOVAL- THIGH NERVE JAN 07

A 08

JAN 08 JAN 08 JAN 08

D 08

Appendix G – CPT Codes for Measures #1 and #2 *Codes with 50 modifier should be excluded as they are bilateral procedures

CPT Code 27320 27323 27324 27327 27328 27329 27330 27331 27332 27333 27334 27335 27340 27345 27347 27350 27355 27356 27357 27358 27360 27365 27372 27381 27386 27390 27391 27392 27393 27394 27395 27396 27397 27400 27403 27405 27407 27409

CPT Description PARTIAL REMOVAL- THIGH NERVE BIOPSY- THIGH SOFT TISSUES BIOPSY- THIGH SOFT TISSUES REMOVAL OF THIGH LESION REMOVAL OF THIGH LESION REMOVE TUMOR- THIGH/KNEE BIOPSY- KNEE JOINT LINING EXPLORE/TREAT KNEE JOINT REMOVAL OF KNEE CARTILAGE REMOVAL OF KNEE CARTILAGE REMOVE KNEE JOINT LINING REMOVE KNEE JOINT LINING REMOVAL OF KNEECAP BURSA REMOVAL OF KNEE CYST REMOVE KNEE CYST REMOVAL OF KNEECAP REMOVE FEMUR LESION REMOVE FEMUR LESION/GRAFT REMOVE FEMUR LESION/GRAFT REMOVE FEMUR LESION/FIXATION PARTIAL REMOVAL- LEG BONE(S) EXTENSIVE LEG SURGERY REMOVAL OF FOREIGN BODY REPAIR/GRAFT KNEECAP TENDON REPAIR/GRAFT OF THIGH MUSCLE INCISION OF THIGH TENDON INCISION OF THIGH TENDONS INCISION OF THIGH TENDONS LENGTHENING OF THIGH TENDON LENGTHENING OF THIGH TENDONS LENGTHENING OF THIGH TENDONS TRANSPLANT OF THIGH TENDON TRANSPLANTS OF THIGH TENDONS REVISE THIGH MUSCLES/TENDONS REPAIR OF KNEE CARTILAGE REPAIR OF KNEE LIGAMENT REPAIR OF KNEE LIGAMENT REPAIR OF KNEE LIGAMENTS

A 07

D 07 JAN 07

A 08

D 08

Appendix G – CPT Codes for Measures #1 and #2 *Codes with 50 modifier should be excluded as they are bilateral procedures

CPT Code 27412 27415 27416 27418 27420 27422 27424 27425 27427 27428 27429 27430 27435 27437 27438 27440 27441 27442 27443 27445 27446 27447 27448 27450 27454 27455 27457 27465 27466 27468 27470 27472 27475 27477 27479 27485 27486 27487

CPT Description AUTOL CHONDROCYTE IMPLANTATION KNEE OSTEOCHONDRAL ALLOGRAFT KNEE OPEN OSTEOCHONDRAL AUTOGRAFT KNEE OPEN REPAIR DEGENERATED KNEECAP REVISION OF UNSTABLE KNEECAP REVISION OF UNSTABLE KNEECAP REVISION/REMOVAL OF KNEECAP LAT RETINACULAR RELEASE OPEN RECONSTRUCTION- KNEE RECONSTRUCTION- KNEE RECONSTRUCTION- KNEE REVISION OF THIGH MUSCLES INCISION OF KNEE JOINT REVISE KNEECAP REVISE KNEECAP WITH IMPLANT REVISION OF KNEE JOINT REVISION OF KNEE JOINT REVISION OF KNEE JOINT REVISION OF KNEE JOINT REVISION OF KNEE JOINT REVISION OF KNEE JOINT TOTAL KNEE ARTHROPLASTY INCISION OF THIGH INCISION OF THIGH REALIGNMENT OF THIGH BONE REALIGNMENT OF KNEE REALIGNMENT OF KNEE SHORTENING OF THIGH BONE LENGTHENING OF THIGH BONE SHORTEN/LENGTHEN THIGHS REPAIR OF THIGH REPAIR/GRAFT OF THIGH SURGERY TO STOP LEG GROWTH SURGERY TO STOP LEG GROWTH SURGERY TO STOP LEG GROWTH SURGERY TO STOP LEG GROWTH REVISE/REPLACE KNEE JOINT REVISE/REPLACE KNEE JOINT

A 07

D 07

A 08

JAN 08

D 08

Appendix G – CPT Codes for Measures #1 and #2 *Codes with 50 modifier should be excluded as they are bilateral procedures

CPT Code 27488 27495 27496 27497 27498 27499 27506 27507 27511 27513 27514 27517 27519 27524 27535 27536 27540 27556 27557 27558 27566 27580 27590 27591 27592 27594 27596 27598 27599 27600 27601 27602 27603 27604 27605 27606 27607 27610

CPT Description REMOVAL OF KNEE PROSTHESIS REINFORCE THIGH DECOMPRESSION OF THIGH/KNEE DECOMPRESSION OF THIGH/KNEE DECOMPRESSION OF THIGH/KNEE DECOMPRESSION OF THIGH/KNEE TREATMENT OF THIGH FRACTURE TREATMENT OF THIGH FRACTURE TREATMENT OF THIGH FRACTURE TREATMENT OF THIGH FRACTURE TREATMENT OF THIGH FRACTURE TREAT THIGH FX GROWTH PLATE TREAT THIGH FX GROWTH PLATE TREAT KNEECAP FRACTURE TREAT KNEE FRACTURE TREAT KNEE FRACTURE TREAT KNEE FRACTURE TREAT KNEE DISLOCATION TREAT KNEE DISLOCATION TREAT KNEE DISLOCATION TREAT KNEECAP DISLOCATION FUSION OF KNEE AMPUTATE LEG AT THIGH AMPUTATE LEG AT THIGH AMPUTATE LEG AT THIGH AMPUTATION FOLLOW-UP SURGERY AMPUTATION FOLLOW-UP SURGERY AMPUTATE LOWER LEG AT KNEE LEG SURGERY PROCEDURE DECOMPRESSION OF LOWER LEG DECOMPRESSION OF LOWER LEG DECOMPRESSION OF LOWER LEG DRAIN LOWER LEG LESION DRAIN LOWER LEG BURSA INCISION OF ACHILLES TENDON INCISION OF ACHILLES TENDON TREAT LOWER LEG BONE LESION EXPLORE/TREAT ANKLE JOINT

A 07

D 07

A 08

D 08

Appendix G – CPT Codes for Measures #1 and #2 *Codes with 50 modifier should be excluded as they are bilateral procedures

CPT Code 27612 27613 27614 27615 27618 27619 27620 27625 27626 27630 27635 27637 27638 27640 27641 27645 27646 27647 27650 27652 27654 27658 27659 27664 27665 27675 27676 27680 27681 27685 27686 27687 27690 27691 27692 27695 27696 27698

CPT Description EXPLORATION OF ANKLE JOINT BIOPSY LOWER LEG SOFT TISSUE BIOPSY LOWER LEG SOFT TISSUE REMOVE TUMOR- LOWER LEG REMOVE LOWER LEG LESION REMOVE LOWER LEG LESION EXPLORE/TREAT ANKLE JOINT REMOVE ANKLE JOINT LINING REMOVE ANKLE JOINT LINING REMOVAL OF TENDON LESION REMOVE LOWER LEG BONE LESION REMOVE/GRAFT LEG BONE LESION REMOVE/GRAFT LEG BONE LESION PARTIAL REMOVAL OF TIBIA PARTIAL REMOVAL OF FIBULA EXTENSIVE LOWER LEG SURGERY EXTENSIVE LOWER LEG SURGERY EXTENSIVE ANKLE/HEEL SURGERY REPAIR ACHILLES TENDON REPAIR/GRAFT ACHILLES TENDON REPAIR OF ACHILLES TENDON REPAIR OF LEG TENDON- EACH REPAIR OF LEG TENDON- EACH REPAIR OF LEG TENDON- EACH REPAIR OF LEG TENDON- EACH REPAIR LOWER LEG TENDONS REPAIR LOWER LEG TENDONS RELEASE OF LOWER LEG TENDON RELEASE OF LOWER LEG TENDONS REVISION OF LOWER LEG TENDON REVISE LOWER LEG TENDONS REVISION OF CALF TENDON REVISE LOWER LEG TENDON REVISE LOWER LEG TENDON REVISE ADDITIONAL LEG TENDON REPAIR OF ANKLE LIGAMENT REPAIR OF ANKLE LIGAMENTS REPAIR OF ANKLE LIGAMENT

A 07

D 07

A 08

D 08

Appendix G – CPT Codes for Measures #1 and #2 *Codes with 50 modifier should be excluded as they are bilateral procedures

CPT Code 27700 27702 27703 27704 27705 27707 27709 27712 27715 27720 27722 27724 27725 27726 27727 27730 27732 27734 27740 27742 27745 27758 27759 27766 27767 27768 27769 27784 27792 27814 27822 27823 27826 27827 27828 27829 27832 27846

CPT Description REVISION OF ANKLE JOINT RECONSTRUCT ANKLE JOINT RECONSTRUCTION- ANKLE JOINT REMOVAL OF ANKLE IMPLANT INCISION OF TIBIA INCISION OF FIBULA INCISION OF TIBIA & FIBULA REALIGNMENT OF LOWER LEG REVISION OF LOWER LEG REPAIR OF TIBIA REPAIR/GRAFT OF TIBIA REPAIR/GRAFT OF TIBIA REPAIR OF LOWER LEG REPAIR FIBULA INTERNAL FIXATION REPAIR OF LOWER LEG REPAIR OF TIBIA EPIPHYSIS REPAIR OF FIBULA EPIPHYSIS REPAIR LOWER LEG EPIPHYSES REPAIR OF LEG EPIPHYSES REPAIR OF LEG EPIPHYSES REINFORCE TIBIA TREATMENT OF TIBIA FRACTURE TREATMENT OF TIBIA FRACTURE TREATMENT OF ANKLE FRACTURE CLOSED TX POST MALL FX W/O, MANIPULAT CLOSED TX POST MALL FX, W MANIPULAT OPEN TX POST MALL, FX W/ INT FIX TREATMENT OF FIBULA FRACTURE TREATMENT OF ANKLE FRACTURE TREATMENT OF ANKLE FRACTURE TREATMENT OF ANKLE FRACTURE TREATMENT OF ANKLE FRACTURE TREAT LOWER LEG FRACTURE TREAT LOWER LEG FRACTURE TREAT LOWER LEG FRACTURE TREAT LOWER LEG JOINT TREAT LOWER LEG DISLOCATION TREAT ANKLE DISLOCATION

A 07

D 07

A 08

JAN 08

JAN 08 JAN 08 JAN 08

D 08

Appendix G – CPT Codes for Measures #1 and #2 *Codes with 50 modifier should be excluded as they are bilateral procedures

CPT Code 27848 27870 27871 27880 27881 27882 27884 27886 27888 27889 27892 27893 27894 27899 28001 28002 28003 28005 28008 28010 28011 28020 28022 28024 28030 28035 28043 28045 28046 28050 28052 28054 28060 28062 28070 28072 28080 28086

CPT Description TREAT ANKLE DISLOCATION FUSION OF ANKLE JOINT- OPEN FUSION OF TIBIOFIBULAR JOINT AMPUTATION OF LOWER LEG AMPUTATION OF LOWER LEG AMPUTATION OF LOWER LEG AMPUTATION FOLLOW-UP SURGERY AMPUTATION FOLLOW-UP SURGERY AMPUTATION OF FOOT AT ANKLE AMPUTATION OF FOOT AT ANKLE DECOMPRESSION OF LEG DECOMPRESSION OF LEG DECOMPRESSION OF LEG LEG/ANKLE SURGERY PROCEDURE DRAINAGE OF BURSA OF FOOT TREATMENT OF FOOT INFECTION TREATMENT OF FOOT INFECTION TREAT FOOT BONE LESION INCISION OF FOOT FASCIA INCISION OF TOE TENDON INCISION OF TOE TENDONS EXPLORATION OF FOOT JOINT EXPLORATION OF FOOT JOINT EXPLORATION OF TOE JOINT REMOVAL OF FOOT NERVE DECOMPRESSION OF TIBIA NERVE EXCISION OF FOOT LESION EXCISION OF FOOT LESION RESECTION OF TUMOR- FOOT BIOPSY OF FOOT JOINT LINING BIOPSY OF FOOT JOINT LINING BIOPSY OF TOE JOINT LINING PARTIAL REMOVAL- FOOT FASCIA REMOVAL OF FOOT FASCIA REMOVAL OF FOOT JOINT LINING REMOVAL OF FOOT JOINT LINING REMOVAL OF FOOT LESION EXCISE FOOT TENDON SHEATH

A 07

D 07

JAN 07

A 08

D 08

Appendix G – CPT Codes for Measures #1 and #2 *Codes with 50 modifier should be excluded as they are bilateral procedures

CPT Code 28088 28090 28092 28100 28102 28103 28104 28106 28107 28108 28110 28111 28112 28113 28114 28116 28118 28119 28120 28122 28124 28130 28140 28150 28160 28171 28173 28175 28190 28192 28193 28200 28202 28208 28210 28220 28222 28225

CPT Description EXCISE FOOT TENDON SHEATH REMOVAL OF FOOT LESION REMOVAL OF TOE LESIONS REMOVAL OF ANKLE/HEEL LESION REMOVE/GRAFT FOOT LESION REMOVE/GRAFT FOOT LESION REMOVAL OF FOOT LESION REMOVE/GRAFT FOOT LESION REMOVE/GRAFT FOOT LESION REMOVAL OF TOE LESIONS PART REMOVAL OF METATARSAL PART REMOVAL OF METATARSAL PART REMOVAL OF METATARSAL PART REMOVAL OF METATARSAL REMOVAL OF METATARSAL HEADS REVISION OF FOOT REMOVAL OF HEEL BONE REMOVAL OF HEEL SPUR PART REMOVAL OF ANKLE/HEEL PARTIAL REMOVAL OF FOOT BONE PARTIAL REMOVAL OF TOE REMOVAL OF ANKLE BONE REMOVAL OF METATARSAL REMOVAL OF TOE PARTIAL REMOVAL OF TOE EXTENSIVE FOOT SURGERY EXTENSIVE FOOT SURGERY EXTENSIVE FOOT SURGERY REMOVAL OF FOOT FOREIGN BODY REMOVAL OF FOOT FOREIGN BODY REMOVAL OF FOOT FOREIGN BODY REPAIR OF FOOT TENDON REPAIR/GRAFT OF FOOT TENDON REPAIR OF FOOT TENDON REPAIR/GRAFT OF FOOT TENDON RELEASE OF FOOT TENDON RELEASE OF FOOT TENDONS RELEASE OF FOOT TENDON

A 07

D 07

A 08

D 08

Appendix G – CPT Codes for Measures #1 and #2 *Codes with 50 modifier should be excluded as they are bilateral procedures

CPT Code 28226 28230 28232 28234 28238 28240 28250 28260 28261 28262 28264 28270 28272 28280 28285 28286 28288 28289 28290 28292 28293 28294 28296 28297 28298 28299 28300 28302 28304 28305 28306 28307 28308 28309 28310 28312 28313 28315

CPT Description RELEASE OF FOOT TENDONS INCISION OF FOOT TENDON(S) INCISION OF TOE TENDON INCISION OF FOOT TENDON REVISION OF FOOT TENDON RELEASE OF BIG TOE REVISION OF FOOT FASCIA RELEASE OF MIDFOOT JOINT REVISION OF FOOT TENDON REVISION OF FOOT AND ANKLE RELEASE OF MIDFOOT JOINT RELEASE OF FOOT CONTRACTURE RELEASE OF TOE JOINT- EACH FUSION OF TOES REPAIR OF HAMMERTOE REPAIR OF HAMMERTOE PARTIAL REMOVAL OF FOOT BONE REPAIR HALLUX RIGIDUS CORRECTION OF BUNION CORRECTION OF BUNION CORRECTION OF BUNION CORRECTION OF BUNION CORRECTION OF BUNION CORRECTION OF BUNION CORRECTION OF BUNION CORRECTION OF BUNION INCISION OF HEEL BONE INCISION OF ANKLE BONE INCISION OF MIDFOOT BONES INCISE/GRAFT MIDFOOT BONES INCISION OF METATARSAL INCISION OF METATARSAL INCISION OF METATARSAL INCISION OF METATARSALS REVISION OF BIG TOE REVISION OF TOE REPAIR DEFORMITY OF TOE REMOVAL OF SESAMOID BONE

A 07

D 07

A 08

D 08

Appendix G – CPT Codes for Measures #1 and #2 *Codes with 50 modifier should be excluded as they are bilateral procedures

CPT Code 28320 28322 28340 28341 28344 28345 28360 28415 28420 28445 28446 28465 28485 28505 28525 28531 28555 28585 28615 28645 28675 28705 28715 28725 28730 28735 28737 28740 28750 28755 28760 28800 28805 28810 28820 28825 28899 29800

CPT Description REPAIR OF FOOT BONES REPAIR OF METATARSALS RESECT ENLARGED TOE TISSUE RESECT ENLARGED TOE REPAIR EXTRA TOE(S) REPAIR WEBBED TOE(S) RECONSTRUCT CLEFT FOOT TREAT HEEL FRACTURE TREAT/GRAFT HEEL FRACTURE TREAT ANKLE FRACTURE OPEN OSTEOCHONDR AUTOGRAFT, TALUS TREAT MIDFOOT FRACTURE- EACH TREAT METATARSAL FRACTURE TREAT BIG TOE FRACTURE TREAT TOE FRACTURE TREAT SESAMOID BONE FRACTURE REPAIR FOOT DISLOCATION REPAIR FOOT DISLOCATION REPAIR FOOT DISLOCATION REPAIR TOE DISLOCATION REPAIR OF TOE DISLOCATION FUSION OF FOOT BONES FUSION OF FOOT BONES FUSION OF FOOT BONES FUSION OF FOOT BONES FUSION OF FOOT BONES REVISION OF FOOT BONES FUSION OF FOOT BONES FUSION OF BIG TOE JOINT FUSION OF BIG TOE JOINT FUSION OF BIG TOE JOINT AMPUTATION OF MIDFOOT AMPUTATION THRU METATARSAL AMPUTATION TOE & METATARSAL AMPUTATION OF TOE PARTIAL AMPUTATION OF TOE FOOT/TOES SURGERY PROCEDURE JAW ARTHROSCOPY/SURGERY

A 07

D 07

A 08

JAN 08

D 08

Appendix G – CPT Codes for Measures #1 and #2 *Codes with 50 modifier should be excluded as they are bilateral procedures

CPT Code 29804 29805 29807 29819 29820 29821 29822 29823 29824 29825 29826 29827 29828 29904 29905 29906 29907 29830 29834 29835 29836 29837 29838 29840 29843 29844 29845 29847 29848 29851 29856 29860 29861 29862 29863 29866 29867

A 07 CPT Description JAW ARTHROSCOPY/SURGERY SHOULDER ARTHROSCOPY- DX SHOULDER ARTHROSCOPY/SURGERY SHOULDER ARTHROSCOPY/SURGERY SHOULDER ARTHROSCOPY/SURGERY SHOULDER ARTHROSCOPY/SURGERY SHOULDER ARTHROSCOPY/SURGERY SHOULDER ARTHROSCOPY/SURGERY SHOULDER ARTHROSCOPY/SURGERY SHOULDER ARTHROSCOPY/SURGERY SHOULDER ARTHROSCOPY/SURGERY OCT 06 SHOULDER ARTHROSCOPY-RC REPAIR SHOULDER ARTHRO W/ BICEPS TENODESIS ARTHRO SUBTALAR JOINT W/ REMOVAL ARTHRO SUBTALAR W/ SYNOVECTOMY ARTHRO SUBTALAR W/ DEBRIDEMENT ARTHRO SUBTALAR ARTHRODESIS ELBOW ARTHROSCOPY ELBOW ARTHROSCOPY/SURGERY ELBOW ARTHROSCOPY/SURGERY ELBOW ARTHROSCOPY/SURGERY ELBOW ARTHROSCOPY/SURGERY ELBOW ARTHROSCOPY/SURGERY WRIST ARTHROSCOPY WRIST ARTHROSCOPY/SURGERY WRIST ARTHROSCOPY/SURGERY WRIST ARTHROSCOPY/SURGERY WRIST ARTHROSCOPY/SURGERY WRIST ENDOSCOPY/SURGERY KNEE ARTHROSCOPY/SURGERY TIBIAL ARTHROSCOPY/SURGERY HIP ARTHROSCOPY- DX HIP ARTHROSCOPY/SURGERY HIP ARTHROSCOPY/SURGERY HIP ARTHROSCOPY/SURGERY SCOPE KNEE; OSTEOCHONDRAL AUTOGRAFT SCOPE KNEE; OSTEOCHONDRAL ALLOGRAFT

D 07

A 08

JAN 08 JAN 08 JAN 08 JAN 08 JAN 08

D 08

Appendix G – CPT Codes for Measures #1 and #2 *Codes with 50 modifier should be excluded as they are bilateral procedures

CPT Code 29868 29870 29871 29873 29874 29875 29876 29877 29879 29880 29881 29882 29883 29884 29885 29886 29887 29888 29889 29891 29892 29893 29894 29895 29897 29898 29899 29900 29901 29902 29999 31239 31290 31291 31292 31293 31294 31300

CPT Description SCOPE KNEE; MENISCAL TPLNT MED/LAT KNEE ARTHROSCOPY- DX KNEE ARTHROSCOPY/DRAINAGE KNEE ARTHROSCOPY/SURGERY KNEE ARTHROSCOPY/SURGERY KNEE ARTHROSCOPY/SURGERY KNEE ARTHROSCOPY/SURGERY KNEE ARTHROSCOPY/SURGERY KNEE ARTHROSCOPY/SURGERY KNEE ARTHROSCOPY/SURGERY KNEE ARTHROSCOPY/SURGERY KNEE ARTHROSCOPY/SURGERY KNEE ARTHROSCOPY/SURGERY KNEE ARTHROSCOPY/SURGERY KNEE ARTHROSCOPY/SURGERY KNEE ARTHROSCOPY/SURGERY KNEE ARTHROSCOPY/SURGERY KNEE ARTHROSCOPY/SURGERY KNEE ARTHROSCOPY/SURGERY ANKLE ARTHROSCOPY/SURGERY ANKLE ARTHROSCOPY/SURGERY SCOPE- PLANTAR FASCIOTOMY ANKLE ARTHROSCOPY/SURGERY ANKLE ARTHROSCOPY/SURGERY ANKLE ARTHROSCOPY/SURGERY ANKLE ARTHROSCOPY/SURGERY ANKLE ARTHROSCOPY/SURGERY MCP JOINT ARTHROSCOPY- DX MCP JOINT ARTHROSCOPY- SURG MCP JOINT ARTHROSCOPY- SURG ARTHROSCOPY OF JOINT NASAL/SINUS ENDOSCOPY- SURG NASAL/SINUS ENDOSCOPY- SURG NASAL/SINUS ENDOSCOPY- SURG NASAL/SINUS ENDOSCOPY- SURG NASAL/SINUS ENDOSCOPY- SURG NASAL/SINUS ENDOSCOPY- SURG REMOVAL OF LARYNX LESION

A 07

D 07

A 08

D 08

Appendix G – CPT Codes for Measures #1 and #2 *Codes with 50 modifier should be excluded as they are bilateral procedures

CPT Code 31320 31367 31368 31370 31375 31380 31382 31400 31420 31510 31513 31528 31529 31535 31536 31545 31546 31560 31561 31570 31571 31576 31579 31580 31582 31584 31585 31586 31587 31588 31590 31595 31599 31603 31605 31611 31612 31615

CPT Description DIAGNOSTIC INCISION- LARYNX PARTIAL REMOVAL OF LARYNX PARTIAL REMOVAL OF LARYNX PARTIAL REMOVAL OF LARYNX PARTIAL REMOVAL OF LARYNX PARTIAL REMOVAL OF LARYNX PARTIAL REMOVAL OF LARYNX REVISION OF LARYNX REMOVAL OF EPIGLOTTIS LARYNGOSCOPY WITH BIOPSY INJECTION INTO VOCAL CORD LARYNGOSCOPY AND DILATION LARYNGOSCOPY AND DILATION OPERATIVE LARYNGOSCOPY OPERATIVE LARYNGOSCOPY LARYN OP MIC REMV LES;RECN TISS FLP LARYN OP MIC REMV LES;RECNSTR W/GFT OPERATIVE LARYNGOSCOPY OPERATIVE LARYNGOSCOPY LARYNGOSCOPY WITH INJECTION LARYNGOSCOPY WITH INJECTION LARYNGOSCOPY WITH BIOPSY DIAGNOSTIC LARYNGOSCOPY REVISION OF LARYNX REVISION OF LARYNX TREAT LARYNX FRACTURE TREAT LARYNX FRACTURE TREAT LARYNX FRACTURE REVISION OF LARYNX REVISION OF LARYNX REINNERVATE LARYNX LARYNX NERVE SURGERY LARYNX SURGERY PROCEDURE INCISION OF WINDPIPE INCISION OF WINDPIPE SURGERY/SPEECH PROSTHESIS PUNCTURE/CLEAR WINDPIPE VISUALIZATION OF WINDPIPE

A 07

D 07

A 08

D 08

Appendix G – CPT Codes for Measures #1 and #2 *Codes with 50 modifier should be excluded as they are bilateral procedures

CPT Code 31628 31629 31631 31633 31638 31640 31641 31656 31715 31750 31755 31760 31766 31775 31780 31781 31785 31786 31899 32002 32005 32019 32020 32035 32036 32095 32100 32110 32120 32124 32140 32141 32150 32151 32200 32201 32215 32220

CPT Description BRNCHSCPY; TRNSBRNCH LUNG BX 1 LOBE BRNCHSCPY;NABX TRACH STEM&/BRNCH BRONCHOSCOPY; PLCMT TRACHEAL STENT BRNCHSCPY; W/TBNA BX EA ADD LOBE BRO;REV TRACH/BRNCH STNT INSRT PREV BRONCHOSCOPY; W/EXCISION OF TUMOR BRONCHOSCOPY- TREAT BLOCKAGE BRONCHOSCOPY- INJ FOR X-RAY INJECTION FOR BRONCHUS X-RAY REPAIR OF WINDPIPE REPAIR OF WINDPIPE REPAIR OF WINDPIPE RECONSTRUCTION OF WINDPIPE RECONSTRUCT BRONCHUS RECONSTRUCT WINDPIPE RECONSTRUCT WINDPIPE REMOVE WINDPIPE LESION REMOVE WINDPIPE LESION AIRWAYS SURGICAL PROCEDURE TREATMENT OF COLLAPSED LUNG TREAT LUNG LINING CHEMICALLY INSRT INDWELL TUNNLD PLEURAL CATH INSERTION OF CHEST TUBE EXPLORATION OF CHEST EXPLORATION OF CHEST BIOPSY THROUGH CHEST WALL EXPLORATION/BIOPSY OF CHEST EXPLORE/REPAIR CHEST RE-EXPLORATION OF CHEST EXPLORE CHEST FREE ADHESIONS REMOVAL OF LUNG LESION(S) REMOVE/TREAT LUNG LESIONS REMOVAL OF LUNG LESION(S) REMOVE LUNG FOREIGN BODY DRAIN- OPEN- LUNG LESION DRAIN- PERCUT- LUNG LESION TREAT CHEST LINING RELEASE OF LUNG

A 07

D 07

A 08

D 08 JAN 08 JAN 08 JAN 08 JAN 08 JAN 08 JAN 08 JAN 08 JAN 08 JAN 08

JAN 08 JAN 08 JAN 08 JAN 08

Appendix G – CPT Codes for Measures #1 and #2 *Codes with 50 modifier should be excluded as they are bilateral procedures

CPT Code 32225 32310 32320 32400 32402 32420 32421 32422 32440 32442 32445 32480 32482 32484 32486 32488 32491 32500 32520 32522 32525 32540 32550 32551 32560 32601 32602 32650 32651 32652 32653 32654 32655 32656 32657 32663 32664 32800

CPT Description PARTIAL RELEASE OF LUNG REMOVAL OF CHEST LINING FREE/REMOVE CHEST LINING NEEDLE BIOPSY CHEST LINING OPEN BIOPSY CHEST LINING PUNCTURE/CLEAR LUNG THORACENTSIS PLEURAL CAVITY THORACENTSIS INSERTION TUBE REMOVAL OF LUNG SLEEVE PNEUMONECTOMY REMOVAL OF LUNG PARTIAL REMOVAL OF LUNG BILOBECTOMY SEGMENTECTOMY SLEEVE LOBECTOMY COMPLETION PNEUMONECTOMY LUNG VOLUME REDUCTION PARTIAL REMOVAL OF LUNG REMOVE LUNG & REVISE CHEST REMOVE LUNG & REVISE CHEST REMOVE LUNG & REVISE CHEST REMOVAL OF LUNG LESION INSERTION INDWELLING PLEURAL CATH TUBE THORACOSTOMY, WATER SEAL CHEMICAL PLEURODESIS THORACOSCOPY- DIAGNOSTIC THORACOSCOPY- DIAGNOSTIC THORACOSCOPY- SURGICAL THORACOSCOPY- SURGICAL THORACOSCOPY- SURGICAL THORACOSCOPY- SURGICAL THORACOSCOPY- SURGICAL THORACOSCOPY- SURGICAL THORACOSCOPY- SURGICAL THORACOSCOPY- SURGICAL THORACOSCOPY- SURGICAL THORACOSCOPY- SURGICAL REPAIR LUNG HERNIA

A 07

D 07

A 08

JAN 08 JAN 08

JAN 08 JAN 08 JAN 08

D 08

Appendix G – CPT Codes for Measures #1 and #2 *Codes with 50 modifier should be excluded as they are bilateral procedures

CPT Code 32820 32851 32852 32900 32905 32906 32940 32960 32999 33282 33284 33606 33619 33690 33750 33755 33762 33764 33766 33767 33802 33803 33820 33822 33824 33840 33845 33851 33852 33853 33860 33861 33863 33870 33875 33877 33910 33915

CPT Description RECONSTRUCT INJURED CHEST LUNG TRANSPLANT- SINGLE LUNG TRANSPLANT WITH BYPASS REMOVAL OF RIB(S) REVISE & REPAIR CHEST WALL REVISE & REPAIR CHEST WALL REVISION OF LUNG THERAPEUTIC PNEUMOTHORAX CHEST SURGERY PROCEDURE IMPLANT PAT-ACTIVE HT RECORD REMOVE PAT-ACTIVE HT RECORD ANASTOMOSIS/ARTERY-AORTA REPAIR SINGLE VENTRICLE REINFORCE PULMONARY ARTERY MAJOR VESSEL SHUNT MAJOR VESSEL SHUNT MAJOR VESSEL SHUNT MAJOR VESSEL SHUNT & GRAFT MAJOR VESSEL SHUNT MAJOR VESSEL SHUNT REPAIR VESSEL DEFECT REPAIR VESSEL DEFECT REVISE MAJOR VESSEL REVISE MAJOR VESSEL REVISE MAJOR VESSEL REMOVE AORTA CONSTRICTION REMOVE AORTA CONSTRICTION REMOVE AORTA CONSTRICTION REPAIR SEPTAL DEFECT REPAIR SEPTAL DEFECT ASCENDING AORTIC GRAFT ASCENDING AORTIC GRAFT ASCENDING AORTIC GRAFT TRANSVERSE AORTIC ARCH GRAFT THORACIC AORTIC GRAFT THORACOABDOMINAL GRAFT REMOVE LUNG ARTERY EMBOLI REMOVE LUNG ARTERY EMBOLI

A 07

D 07

OCT 06

A 08

D 08

Appendix G – CPT Codes for Measures #1 and #2 *Codes with 50 modifier should be excluded as they are bilateral procedures

CPT Code 33916 33917 33918 33919 33922 33935 34001 34051 34101 34111 34151 34201 34203 34401 34421 34451 34471 34490 34502 34520 34530 34808 34900 35001 35002 35005 35011 35013 35021 35022 35045 35081 35082 35091 35092 35102 35103 35111

CPT Description SURGERY OF GREAT VESSEL REPAIR PULMONARY ARTERY REPAIR PULMONARY ATRESIA REPAIR PULMONARY ATRESIA TRANSECT PULMONARY ARTERY TRANSPLANTATION- HEART/LUNG REMOVAL OF ARTERY CLOT REMOVAL OF ARTERY CLOT REMOVAL OF ARTERY CLOT REMOVAL OF ARM ARTERY CLOT REMOVAL OF ARTERY CLOT REMOVAL OF ARTERY CLOT REMOVAL OF LEG ARTERY CLOT REMOVAL OF VEIN CLOT REMOVAL OF VEIN CLOT REMOVAL OF VEIN CLOT REMOVAL OF VEIN CLOT REMOVAL OF VEIN CLOT RECONSTRUCT VENA CAVA CROSS-OVER VEIN GRAFT LEG VEIN FUSION ENDOVASC ABDO OCCLUD DEVICE ENDOVASC GRAFT PLCMT REP ILIAC ART REPAIR DEFECT OF ARTERY REPAIR ARTERY RUPTURE- NECK REPAIR DEFECT OF ARTERY REPAIR DEFECT OF ARTERY REPAIR ARTERY RUPTURE- ARM REPAIR DEFECT OF ARTERY REPAIR ARTERY RUPTURE- CHEST REPAIR DEFECT OF ARM ARTERY REPAIR DEFECT OF ARTERY REPAIR ARTERY RUPTURE- AORTA REPAIR DEFECT OF ARTERY REPAIR ARTERY RUPTURE- AORTA REPAIR DEFECT OF ARTERY REPAIR ARTERY RUPTURE- GROIN REPAIR DEFECT OF ARTERY

A 07

D 07

A 08

D 08

Appendix G – CPT Codes for Measures #1 and #2 *Codes with 50 modifier should be excluded as they are bilateral procedures

CPT Code 35112 35121 35122 35131 35132 35141 35142 35151 35152 35180 35182 35184 35188 35189 35190 35301 35311 35331 35341 35351 35355 35361 35363 35371 35372 35381 35400 35500 35501 35506 35507 35509 35511 35512 35515 35516 35518 35521

CPT Description REPAIR ARTERY RUPTURE-SPLEEN REPAIR DEFECT OF ARTERY REPAIR ARTERY RUPTURE- BELLY REPAIR DEFECT OF ARTERY REPAIR ARTERY RUPTURE- GROIN REPAIR DEFECT OF ARTERY REPAIR ARTERY RUPTURE- THIGH REPAIR DEFECT OF ARTERY REPAIR ARTERY RUPTURE- KNEE REPAIR BLOOD VESSEL LESION REPAIR BLOOD VESSEL LESION REPAIR BLOOD VESSEL LESION REPAIR BLOOD VESSEL LESION REPAIR BLOOD VESSEL LESION REPAIR BLOOD VESSEL LESION RECHANNELING OF ARTERY RECHANNELING OF ARTERY RECHANNELING OF ARTERY RECHANNELING OF ARTERY RECHANNELING OF ARTERY RECHANNELING OF ARTERY RECHANNELING OF ARTERY RECHANNELING OF ARTERY RECHANNELING OF ARTERY RECHANNELING OF ARTERY RECHANNELING OF ARTERY ANGIOSCOPY HARVEST VEIN FOR BYPASS ARTERY BYPASS GRAFT ARTERY BYPASS GRAFT ARTERY BYPASS GRAFT ARTERY BYPASS GRAFT ARTERY BYPASS GRAFT BYPS GRAFT W/VEIN; SUBCLAVIAN-BRACH ARTERY BYPASS GRAFT ARTERY BYPASS GRAFT ARTERY BYPASS GRAFT ARTERY BYPASS GRAFT

A 07

D 07

JAN 07

JAN 07

A 08

D 08

Appendix G – CPT Codes for Measures #1 and #2 *Codes with 50 modifier should be excluded as they are bilateral procedures

CPT Code 35522 35523 35525 35526 35533 35536 35541 35546 35548 35549 35551 35556 35558 35560 35565 35566 35571 35583 35585 35587 35601 35606 35612 35616 35621 35623 35626 35631 35636 35641 35645 35646 35647 35650 35651 35654 35656 35661

CPT Description BYPASS GRAFT W/VEIN; AX-BRACHIAL BYPASS GRAFT W/ BRACHIAL ULNAR/RADIAL BYPASS GRAFT W/VEIN; BRACH-BRACH ARTERY BYPASS GRAFT ARTERY BYPASS GRAFT ARTERY BYPASS GRAFT ARTERY BYPASS GRAFT ARTERY BYPASS GRAFT ARTERY BYPASS GRAFT ARTERY BYPASS GRAFT ARTERY BYPASS GRAFT ARTERY BYPASS GRAFT ARTERY BYPASS GRAFT ARTERY BYPASS GRAFT ARTERY BYPASS GRAFT ARTERY BYPASS GRAFT ARTERY BYPASS GRAFT VEIN BYPASS GRAFT VEIN BYPASS GRAFT VEIN BYPASS GRAFT ARTERY BYPASS GRAFT ARTERY BYPASS GRAFT ARTERY BYPASS GRAFT ARTERY BYPASS GRAFT ARTERY BYPASS GRAFT BYPASS GRAFT- NOT VEIN ARTERY BYPASS GRAFT ARTERY BYPASS GRAFT ARTERY BYPASS GRAFT ARTERY BYPASS GRAFT ARTERY BYPASS GRAFT ARTERY BYPASS GRAFT ARTERY BYPASS GRAFT ARTERY BYPASS GRAFT ARTERY BYPASS GRAFT ARTERY BYPASS GRAFT ARTERY BYPASS GRAFT ARTERY BYPASS GRAFT

A 07

D 07

A 08 JAN 08

JAN 07 JAN 07

JAN 07

D 08

Appendix G – CPT Codes for Measures #1 and #2 *Codes with 50 modifier should be excluded as they are bilateral procedures

CPT Code 35665 35666 35671 35693 35694 35695 35701 35721 35741 35761 35800 35820 35840 35860 35870 36013 36014 36015 36100 36120 36140 36160 36200 36215 36216 36217 36218 36245 36246 36247 36248 36260 36262 36299 36400 36405 36406 36410

CPT Description ARTERY BYPASS GRAFT ARTERY BYPASS GRAFT ARTERY BYPASS GRAFT ARTERIAL TRANSPOSITION ARTERIAL TRANSPOSITION ARTERIAL TRANSPOSITION EXPLORATION- CAROTID ARTERY EXPLORATION- FEMORAL ARTERY EXPLORATION POPLITEAL ARTERY EXPLORATION OF ARTERY/VEIN EXPLORE NECK VESSELS EXPLORE CHEST VESSELS EXPLORE ABDOMINAL VESSELS EXPLORE LIMB VESSELS REPAIR VESSEL GRAFT DEFECT PLACE CATHETER IN ARTERY PLACE CATHETER IN ARTERY PLACE CATHETER IN ARTERY ESTABLISH ACCESS TO ARTERY ESTABLISH ACCESS TO ARTERY ESTABLISH ACCESS TO ARTERY ESTABLISH ACCESS TO AORTA PLACE CATHETER IN AORTA PLACE CATHETER IN ARTERY PLACE CATHETER IN ARTERY PLACE CATHETER IN ARTERY PLACE CATHETER IN ARTERY PLACE CATHETER IN ARTERY PLACE CATHETER IN ARTERY PLACE CATHETER IN ARTERY PLACE CATHETER IN ARTERY INSERTION OF INFUSION PUMP REMOVAL OF INFUSION PUMP VESSEL INJECTION PROCEDURE VENIPUNCT UND AGE 3 YR; FEM/JUGULAR VENIPUNCT UNDER AGE 3 YR; SCLP VEIN VENIPUNCT UNDER AGE 3 YR; OTH VEIN VENIPUNCT AGE 3 MD SKILL SEP PROC

A 07

D 07

A 08

D 08

Appendix G – CPT Codes for Measures #1 and #2 *Codes with 50 modifier should be excluded as they are bilateral procedures

CPT Code 36415 36416 36420 36425 36468 36469 36470 36471 36475 36476 36478 36479 36510 36555 36556 36557 36558 36568 36569 36575 36580 36581 36584 36589 36590 36597 36600 36620 36625 36640 36660 36680 36800 36810 36815 36818 36819 36820

CPT Description ROUTINE VENIPUNCTURE CAPILLARY BLOOD DRAW VEIN ACCESS CUTDOWN < 1 YR VEIN ACCESS CUTDOWN > 1 YR INJECTION(S)- SPIDER VEINS INJECTION(S)- SPIDER VEINS INJECTION THERAPY OF VEIN INJECTION THERAPY OF VEINS ENDOVENUS ABLAT TX VEIN EXT RF;1 VN ENDOVEN ABLAT TX EXT RF;2&>VNS 1EXT ENDOVEN ABLAT TX VN EXT LASR; 1 VN ENDOVEN ABLAT VN EXT LASR; 2&>1 EXT INSERTION OF CATHETER- VEIN INSRT NON-TUNNL CNTRL CVC; INSRT TUNNL CVC NO PORT/PUMP; INSERT PICC W/O PORT/PUMP; < 5 YR INSERT PICC W/O PORT/PUMP; 5 YR/> REP CV ACSS CATH W/O PORT/PUMP REPL NON-TUNNLD CVC W/O PORT/PUMP REPL TUNNLD CNTRL CVC W/O PORT/PUMP REPL PICC W/O PORT/PUMP SAME ACSS REMV TUNNLD CVC W/O SUBQ PORT/PUMP REMV TUNNLD CVAD W/SUBQ PORT/PUMP REPSTN PREV PLCD CVC FLUORO GUID WITHDRAWAL OF ARTERIAL BLOOD INSERTION CATHETER- ARTERY INSERTION CATHETER- ARTERY INSERTION CATHETER- ARTERY INSERTION CATHETER- ARTERY INSERT NEEDLE- BONE CAVITY INSERTION OF CANNULA INSERTION OF CANNULA INSERTION OF CANNULA AV ANAST OPN;ARM CEPHAL VN TRNSPSTN AV FUSION/UPPR ARM VEIN AV FUSION/FOREARM VEIN

A 07

D 07

A 08

D 08

Appendix G – CPT Codes for Measures #1 and #2 *Codes with 50 modifier should be excluded as they are bilateral procedures

CPT Code 36821 36823 36835 37140 37145 37160 37180 37181 37182 37184 37185 37186 37187 37188 37200 37201 37202 37204 37205 37206 37207 37208 37209 37500 37501 37565 37600 37605 37606 37609 37615 37616 37617 37618 37620 37660 37700 37720

CPT Description AV FUSION DIRECT ANY SITE INSERTION OF CANNULA(S) ARTERY TO VEIN SHUNT REVISION OF CIRCULATION REVISION OF CIRCULATION REVISION OF CIRCULATION REVISION OF CIRCULATION SPLICE SPLEEN/KIDNEY VEINS INSERT HEPATIC SHUNT (TIPS) PERC MECH ART THROMB-1st PERC MECH ART THROMB-2nd 2nd PERC THROMB NON-COR PERC MECH VEIN THROMB PERC MECH THROMB VN-REPT TRANSCATHETER BIOPSY TRANSCATHETER THERAPY INFUSE TRANSCATHETER THERAPY INFUSE TRANSCATHETER OCCLUSION TRANSCATH IVASC STENT PERQ;INIT VES TRANSCATH IVASC STENT PERQ; EA ADD TRANSCATHETER STENT TRANSCATHETER STENT ADD-ON EXCHANGE INTRAVASCULAR CATHETER ENDOSCOPY LIGATE PERF VEINS VASCULAR ENDOSCOPY PROCEDURE LIGATION OF NECK VEIN LIGATION OF NECK ARTERY LIGATION OF NECK ARTERY LIGATION OF NECK ARTERY TEMPORAL ARTERY PROCEDURE LIGATION OF NECK ARTERY LIGATION OF CHEST ARTERY LIGATION OF ABDOMEN ARTERY LIGATION OF EXTREMITY ARTERY REVISION OF MAJOR VEIN REVISION OF MAJOR VEIN REVISE LEG VEIN REMOVAL OF LEG VEIN

A 07

D 07

OCT 06 OCT 06 OCT 06 OCT 06 OCT 06

A 08

D 08

Appendix G – CPT Codes for Measures #1 and #2 *Codes with 50 modifier should be excluded as they are bilateral procedures

CPT Code 37730 37735 37760 37765 37766 37780 37785 37799 38230 38240 38241 38242 38300 38305 38308 38999 39499 39560 39561 39599 41150 41155 42210 43243 44378 47561 49321 49322 49491 49492 49495 49496 49500 49501 49505 49507 49520 49521

CPT Description REMOVAL OF LEG VEINS REMOVAL OF LEG VEINS/LESION LIGATION- LEG VEINS- OPEN STAB PHLEBECT VV 1 EXT; 10-20 INCI STAB PHLEBECT VV 1 EXT; >20 INCI REVISION OF LEG VEIN LIG &/ EXC VARICOSE VN CLUSTR 1 LEG VASCULAR SURGERY PROCEDURE BONE MARROW COLLECTION BONE MARROW/STEM TRANSPLANT BONE MARROW/STEM TRANSPLANT LYMPHOCYTE INFUSE TRANSPLANT DRAINAGE- LYMPH NODE LESION DRAINAGE- LYMPH NODE LESION INCISION OF LYMPH CHANNELS BLOOD/LYMPH SYSTEM PROCEDURE CHEST PROCEDURE RESECT DIAPHRAGM- SIMPLE RESECT DIAPHRAGM- COMPLEX DIAPHRAGM SURGERY PROCEDURE TONGUE- MOUTH- JAW SURGERY TONGUE- JAW- & NECK SURGERY RECONSTRUCT CLEFT PALATE UPPER GI ENDOSCOPY & INJECT SMALL BOWEL ENDOSCOPY LAPARO W/CHOLANGIO/BIOPSY LAPAROSCOPY- BIOPSY LAPAROSCOPY- ASPIRATION RPR HERN PREEMIE REDUC RPR ING HERN PREMIE- BLOCKED RPR ING HERNIA BABY- REDUC RPR ING HERNIA BABY- BLOCKED RPR ING HERNIA- INIT- REDUCE RPR ING HERNIA- INIT BLOCKED PRP I/HERN INIT REDUC>5 YR PRP I/HERN INIT BLOCK>5 YR REREPAIR ING HERNIA- REDUCE REREPAIR ING HERNIA- BLOCKED

A 07

D 07

OCT 06

A 08

D 08

Appendix G – CPT Codes for Measures #1 and #2 *Codes with 50 modifier should be excluded as they are bilateral procedures

CPT Code 49525 49550 49553 49555 49557 49650 49651 49659 49904 50010 50020 50021 50040 50045 50060 50065 50070 50075 50080 50081 50120 50125 50130 50135 50200 50205 50220 50225 50230 50234 50236 50240 50280 50320 50340 50360 50365 50370

CPT Description REPAIR ING HERNIA- SLIDING RPR REM HERNIA- INIT- REDUCE RPR FEM HERNIA- INIT BLOCKED REREPAIR FEM HERNIA- REDUCE REREPAIR FEM HERNIA- BLOCKED LAPARO HERNIA REPAIR INITIAL LAPARO HERNIA REPAIR RECUR LAPARO PROC- HERNIA REPAIR OMENTAL FLAP- EXTRA-ABDOM EXPLORATION OF KIDNEY RENAL ABSCESS- OPEN DRAIN RENAL ABSCESS- PERCUT DRAIN DRAINAGE OF KIDNEY EXPLORATION OF KIDNEY REMOVAL OF KIDNEY STONE INCISION OF KIDNEY INCISION OF KIDNEY REMOVAL OF KIDNEY STONE REMOVAL OF KIDNEY STONE REMOVAL OF KIDNEY STONE EXPLORATION OF KIDNEY EXPLORE AND DRAIN KIDNEY REMOVAL OF KIDNEY STONE EXPLORATION OF KIDNEY BIOPSY OF KIDNEY BIOPSY OF KIDNEY REMOVE KIDNEY- OPEN REMOVAL KIDNEY OPEN- COMPLEX REMOVAL KIDNEY OPEN- RADICAL REMOVAL OF KIDNEY & URETER REMOVAL OF KIDNEY & URETER PARTIAL REMOVAL OF KIDNEY REMOVAL OF KIDNEY LESION DONOR NEPRECTOMY; OPEN LIVING DONOR REMOVAL OF KIDNEY RENAL ALLOTRANSPL;W/O DONR NEPHRECT TRANSPLANTATION OF KIDNEY REMOVE TRANSPLANTED KIDNEY

A 07

D 07

A 08

D 08

Appendix G – CPT Codes for Measures #1 and #2 *Codes with 50 modifier should be excluded as they are bilateral procedures

CPT Code 50380 50390 50392 50393 50394 50395 50398 50400 50405 50520 50525 50526 50540 50541 50542 50543 50544 50545 50546 50547 50548 50549 50555 50557 50562 50574 50575 50576 50650 50660 50700 50740 50750 50840 50930 50940 50957 50972

CPT Description REIMPLANTATION OF KIDNEY DRAINAGE OF KIDNEY LESION INSERT KIDNEY DRAIN INSERT URETERAL TUBE INJECTION FOR KIDNEY X-RAY CREATE PASSAGE TO KIDNEY CHANGE KIDNEY TUBE REVISION OF KIDNEY/URETER REVISION OF KIDNEY/URETER CLOSE KIDNEY-SKIN FISTULA REPAIR RENAL-ABDOMEN FISTULA REPAIR RENAL-ABDOMEN FISTULA REVISION OF HORSESHOE KIDNEY LAPARO ABLATE RENAL CYST LAPARO ABLATE RENAL MASS LAPARO PARTIAL NEPHRECTOMY LAPAROSCOPY- PYELOPLASTY LAPARO RADICAL NEPHRECTOMY LAPAROSCOPIC NEPHRECTOMY LAP SURG; DONR NEPHRECT-LIVING DONR LAPARO REMOVE K/URETER LAPAROSCOPE PROC- RENAL KIDNEY ENDOSCOPY & BIOPSY KIDNEY ENDOSCOPY & TREATMENT RENAL SCOPE W/TUMOR RESECT KIDNEY ENDOSCOPY & BIOPSY KIDNEY ENDOSCOPY KIDNEY ENDOSCOPY & TREATMENT REMOVAL OF URETER REMOVAL OF URETER REVISION OF URETER FUSION OF URETER & KIDNEY FUSION OF URETER & KIDNEY REPLACE URETER BY BOWEL CLOSURE URETER/BOWEL FISTULA RELEASE OF URETER URETER ENDOSCOPY & TREATMENT URETER ENDOSCOPY & CATHETER

A 07

D 07

A 08

D 08

Appendix G – CPT Codes for Measures #1 and #2 *Codes with 50 modifier should be excluded as they are bilateral procedures

CPT Code 50976 51535 52007 52300 52301 52327 52334 52343 52346 52354 52355 53899 54640 55540 57287 57531 58150 58152 58180 58200 58210 58262 58263 58291 58292 58340 58345 58350 58410 58552 58554 58615 58660 58661 58662 58673 58679 58700

CPT Description URETER ENDOSCOPY & TREATMENT REPAIR OF URETER LESION CYSTOSCOPY AND BIOPSY CYSTOSCOPY AND TREATMENT CYSTOSCOPY AND TREATMENT CYSTOSCOPY- INJECT MATERIAL CREATE PASSAGE TO KIDNEY CYSTO W/RENAL STRICTURE TX CYSTOURETERO W/RENAL STRICT CYSTOURETERO W/BIOPSY CYSTOURETERO W/EXCISE TUMOR UROLOGY SURGERY PROCEDURE SUSPENSION OF TESTIS REVISE HERNIA & SPERM VEINS REVISE/REMOVE SLING REPAIR REMOVAL OF CERVIX- RADICAL TOTAL HYSTERECTOMY TOTAL HYSTERECTOMY PARTIAL HYSTERECTOMY EXTENSIVE HYSTERECTOMY EXTENSIVE HYSTERECTOMY VAG HYST INCLUDING T/O VAG HYST W/T/O & VAG REPAIR VAG HYST INCL T/O- COMPLEX VAG HYST T/O & REPAIR- COMPL CATH&INTRO SALINE/CONTRAST SIS/HSG REOPEN FALLOPIAN TUBE REOPEN FALLOPIAN TUBE SUSPENSION OF UTERUS LAPARO-VAG HYST INCL T/O LAPARO-VAG HYST W/T/O- COMPL OCCLUDE FALLOPIAN TUBE(S) LAPAROSCOPY- LYSIS LAPAROSCOPY- REMOVE ADNEXA LAPAROSCOPY- EXCISE LESIONS LAPAROSCOPY- SALPINGOSTOMY LAPARO PROC- OVIDUCT-OVARY REMOVAL OF FALLOPIAN TUBE

A 07

D 07

A 08

D 08

Appendix G – CPT Codes for Measures #1 and #2 *Codes with 50 modifier should be excluded as they are bilateral procedures

CPT Code 58720 58740 58750 58752 58770 58800 58805 58820 58822 58823 58825 58900 58920 58925 58940 58943 58970 58974 58976 58999 59120 59121 59150 59151 60600 60605 61026 61055 61070 61107 61120 61140 61150 61151 61154 61156 61210 61250

CPT Description REMOVAL OF OVARY/TUBE(S) REVISE FALLOPIAN TUBE(S) REPAIR OVIDUCT REVISE OVARIAN TUBE(S) CREATE NEW TUBAL OPENING DRAINAGE OF OVARIAN CYST(S) DRAINAGE OF OVARIAN CYST(S) DRAIN OVARY ABSCESS- OPEN DRAIN OVARY ABSCESS- PERCUT DRAIN PELVIC ABSCESS- PERCUT TRANSPOSITION- OVARY(S) BIOPSY OF OVARY(S) PARTIAL REMOVAL OF OVARY(S) REMOVAL OF OVARIAN CYST(S) REMOVAL OF OVARY(S) REMOVAL OF OVARY(S) RETRIEVAL OF OOCYTE TRANSFER OF EMBRYO TRANSFER OF EMBRYO GENITAL SURGERY PROCEDURE TREAT ECTOPIC PREGNANCY TREAT ECTOPIC PREGNANCY TREAT ECTOPIC PREGNANCY TREAT ECTOPIC PREGNANCY REMOVE CAROTID BODY LESION REMOVE CAROTID BODY LESION INJECTION INTO BRAIN CANAL INJECTION INTO BRAIN CANAL BRAIN CANAL SHUNT PROCEDURE DRILL SKULL FOR IMPLANTATION BURR HOLE FOR PUNCTURE PIERCE SKULL FOR BIOPSY PIERCE SKULL FOR DRAINAGE PIERCE SKULL FOR DRAINAGE PIERCE SKULL & REMOVE CLOT PIERCE SKULL FOR DRAINAGE PIERCE SKULL- IMPLANT DEVICE PIERCE SKULL & EXPLORE

A 07

D 07

A 08

D 08

Appendix G – CPT Codes for Measures #1 and #2 *Codes with 50 modifier should be excluded as they are bilateral procedures

CPT Code 61253 61304 61305 61312 61313 61314 61315 61316 61320 61321 61322 61323 61333 61340 61343 61345 61440 61450 61458 61460 61470 61480 61490 61500 61501 61510 61512 61514 61516 61518 61519 61520 61521 61522 61524 61526 61530 61531

CPT Description PIERCE SKULL & EXPLORE OPEN SKULL FOR EXPLORATION OPEN SKULL FOR EXPLORATION OPEN SKULL FOR DRAINAGE OPEN SKULL FOR DRAINAGE OPEN SKULL FOR DRAINAGE OPEN SKULL FOR DRAINAGE IMPLT CRAN BONE FLAP TO ABDO OPEN SKULL FOR DRAINAGE OPEN SKULL FOR DRAINAGE DECOMPRESSIVE CRANIOTOMY DECOMPRESSIVE LOBECTOMY EXPLORE ORBIT/REMOVE LESION SUBTEMPORAL DECOMPRESSION INCISE SKULL (PRESS RELIEF) RELIEVE CRANIAL PRESSURE INCISE SKULL FOR SURGERY INCISE SKULL FOR SURGERY INCISE SKULL FOR BRAIN WOUND INCISE SKULL FOR SURGERY INCISE SKULL FOR SURGERY INCISE SKULL FOR SURGERY INCISE SKULL FOR SURGERY REMOVAL OF SKULL LESION REMOVE INFECTED SKULL BONE REMOVAL OF BRAIN LESION REMOVE BRAIN LINING LESION REMOVAL OF BRAIN ABSCESS REMOVAL OF BRAIN LESION REMOVAL OF BRAIN LESION REMOVE BRAIN LINING LESION REMOVAL OF BRAIN LESION REMOVAL OF BRAIN LESION REMOVAL OF BRAIN ABSCESS REMOVAL OF BRAIN LESION REMOVAL OF BRAIN LESION REMOVAL OF BRAIN LESION IMPLANT BRAIN ELECTRODES

A 07

D 07

A 08

D 08

Appendix G – CPT Codes for Measures #1 and #2 *Codes with 50 modifier should be excluded as they are bilateral procedures

CPT Code 61533 61534 61536 61537 61538 61539 61540 61541 61542 61543 61544 61550 61552 61556 61557 61558 61559 61563 61564 61566 61567 61570 61571 61575 61576 61600 61601 61605 61606 61607 61608 61609 61610 61611 61612 61613 61615

CPT Description IMPLANT BRAIN ELECTRODES REMOVAL OF BRAIN LESION REMOVAL OF BRAIN LESION CRANIOT; LOBECT TEMPORL W/O ECOG CRANIOT W/FLAP; LOBECTOMY TEMP LOBE CRANIOT W/FLAP;LOBECT-NOT TEMP LOBE CRANIOT; LOBECT NO TEMPORL NO ECOG INCISION OF BRAIN TISSUE REMOVAL OF BRAIN TISSUE CRANIOTOMY; PART HEMISPHERECTOMY REMOVE & TREAT BRAIN LESION RELEASE OF SKULL SEAMS RELEASE OF SKULL SEAMS INCISE SKULL/SUTURES INCISE SKULL/SUTURES EXCISION OF SKULL/SUTURES EXCISION OF SKULL/SUTURES EXCISION OF SKULL TUMOR EXCISION OF SKULL TUMOR CRANIOT;SELCTV AMYGDALOHIPPOCAMPECT CRANIOT; MX SUBPIAL TRANSECT W/ECOG REMOVE FOREIGN BODY- BRAIN INCISE SKULL FOR BRAIN WOUND SKULL BASE/BRAINSTEM SURGERY SKULL BASE/BRAINSTEM SURGERY RESECT/EXCISE CRANIAL LESION RESECT/EXCISE CRANIAL LESION RESECT/EXCISE CRANIAL LESION RESECT/EXCISE CRANIAL LESION RESECT/EXCISE CRANIAL LESION RESECT/EXCISE CRANIAL LESION TRANSECT ARTERY- SINUS TRANSECT ARTERY- SINUS TRANSECT ARTERY- SINUS TRANSECT ARTERY- SINUS REMOVE ANEURYSM- SINUS RESECT/EXCISE LESION- SKULL

A 07

D 07

A 08

D 08

Appendix G – CPT Codes for Measures #1 and #2 *Codes with 50 modifier should be excluded as they are bilateral procedures

CPT Code 61616 61618 61619 61624 61626 61680 61682 61684 61686 61690 61692 61697 61698 61700 61702 61703 61705 61708 61710 61720 61735 61750 61751 61760 61770 61790 61791 61793 61850 61860 61863 61864 61867 61868 61870 61875 61880 61885

CPT Description RESECT/EXCISE LESION- SKULL REPAIR DURA REPAIR DURA TRANSCATH OCCLUSION- CNS TRANSCATH OCCLUSION- NON-CNS INTRACRANIAL VESSEL SURGERY INTRACRANIAL VESSEL SURGERY INTRACRANIAL VESSEL SURGERY INTRACRANIAL VESSEL SURGERY INTRACRANIAL VESSEL SURGERY INTRACRANIAL VESSEL SURGERY BRAIN ANEURYSM REPR- COMPLX BRAIN ANEURYSM REPR- COMPLX BRAIN ANEURYSM REPR- SIMPLE INNER SKULL VESSEL SURGERY CLAMP NECK ARTERY REVISE CIRCULATION TO HEAD REVISE CIRCULATION TO HEAD REVISE CIRCULATION TO HEAD INCISE SKULL/BRAIN SURGERY INCISE SKULL/BRAIN SURGERY INCISE SKULL/BRAIN BIOPSY BRAIN BIOPSY W/CT/MR GUIDE IMPLANT BRAIN ELECTRODES INCISE SKULL FOR TREATMENT TREAT TRIGEMINAL NERVE TREAT TRIGEMINAL TRACT FOCUS RADIATION BEAM IMPLANT NEUROELECTRODES IMPLANT NEUROELECTRODES TWST DRL BURR CRANIOT NO REC;1 ARAY TWST DRL BURR CRANIOT NO REC;EA ADD TWST DRL BURR CRANIOT W/REC;1 ARRAY TWST DRL BURR CRANIOT W/REC; EA ADD IMPLANT NEUROELECTRODES IMPLANT NEUROELECTRODES REVISE/REMOVE NEUROELECTRODE INSRT/REPL CRAN NEUROSTIM; 1 ARRAY

A 07

D 07

A 08

D 08

Appendix G – CPT Codes for Measures #1 and #2 *Codes with 50 modifier should be excluded as they are bilateral procedures

CPT Code 61886 61888 62000 62005 62010 62100 62115 62116 62117 62120 62121 62140 62141 62142 62143 62145 62146 62147 62161 62162 62163 62164 62180 62190 62192 62194 62200 62201 62220 62223 62225 62230 62256 62258 62263 62264 62272 62280

CPT Description INSRT/REPL CRAN NEUROSTM; 2/>ARRAYS REVISE/REMOVE NEURORECEIVER TREAT SKULL FRACTURE TREAT SKULL FRACTURE TREATMENT OF HEAD INJURY REPAIR BRAIN FLUID LEAKAGE REDUCTION OF SKULL DEFECT REDUCTION OF SKULL DEFECT REDUCTION OF SKULL DEFECT REPAIR SKULL CAVITY LESION INCISE SKULL REPAIR REPAIR OF SKULL DEFECT REPAIR OF SKULL DEFECT REMOVE SKULL PLATE/FLAP REPLACE SKULL PLATE/FLAP REPAIR OF SKULL & BRAIN REPAIR OF SKULL WITH GRAFT REPAIR OF SKULL WITH GRAFT DISSECT BRAIN W/SCOPE REMOVE COLLOID CYST W/SCOPE NEUROENDOSCOPY W/FB REMOVAL REMOVE BRAIN TUMOR W/SCOPE ESTABLISH BRAIN CAVITY SHUNT ESTABLISH BRAIN CAVITY SHUNT ESTABLISH BRAIN CAVITY SHUNT REPLACE/IRRIGATE CATHETER ESTABLISH BRAIN CAVITY SHUNT BRAIN CAVITY SHUNT W/SCOPE ESTABLISH BRAIN CAVITY SHUNT ESTABLISH BRAIN CAVITY SHUNT REPLACE/IRRIGATE CATHETER REPLACE/REVISE BRAIN SHUNT REMOVE BRAIN CAVITY SHUNT REPLACE BRAIN CAVITY SHUNT EPIDURAL LYSIS MULT SESSIONS EPIDURAL LYSIS ON SINGLE DAY DRAIN CEREBRO SPINAL FLUID TREAT SPINAL CORD LESION

A 07

D 07

A 08

D 08

Appendix G – CPT Codes for Measures #1 and #2 *Codes with 50 modifier should be excluded as they are bilateral procedures

CPT Code 62281 62282 62287 62292 62294 62355 62365 63001 63003 63005 63011 63012 63015 63016 63017 63020 63030 63035 63040 63042 63043 63044 63045 63046 63047 63048 63050 63055 63056 63057 63064 63066 63075 63076 63077 63078 63081 63082

CPT Description TREAT SPINAL CORD LESION TREAT SPINAL CANAL LESION PERCUTANEOUS DISKECTOMY INJECTION INTO DISK LESION INJECTION INTO SPINAL ARTERY REMOVE SPINAL CANAL CATHETER REMOVE SPINE INFUSION DEVICE REMOVAL OF SPINAL LAMINA REMOVAL OF SPINAL LAMINA REMOVAL OF SPINAL LAMINA REMOVAL OF SPINAL LAMINA REMOVAL OF SPINAL LAMINA REMOVAL OF SPINAL LAMINA REMOVAL OF SPINAL LAMINA REMOVAL OF SPINAL LAMINA NECK SPINE DISK SURGERY LOW BACK DISK SURGERY SPINAL DISK SURGERY ADD-ON LAMINOTOMY- SINGLE CERVICAL LAMINOTOMY- SINGLE LUMBAR LAMINOTOMY- ADDL CERVICAL LAMINOTOMY- ADDL LUMBAR REMOVAL OF SPINAL LAMINA REMOVAL OF SPINAL LAMINA REMOVAL OF SPINAL LAMINA REMOVE SPINAL LAMINA ADD-ON LAMINOPLSTY CERV 2/> VERT SEG; DECOMPRESS SPINAL CORD DECOMPRESS SPINAL CORD DECOMPRESS SPINE CORD ADD-ON DECOMPRESS SPINAL CORD DECOMPRESS SPINE CORD ADD-ON NECK SPINE DISK SURGERY NECK SPINE DISK SURGERY SPINE DISK SURGERY- THORAX SPINE DISK SURGERY- THORAX REMOVAL OF VERTEBRAL BODY REMOVE VERTEBRAL BODY ADD-ON

A 07

D 07

A 08

D 08

Appendix G – CPT Codes for Measures #1 and #2 *Codes with 50 modifier should be excluded as they are bilateral procedures

CPT Code 63085 63086 63087 63088 63090 63091 63101 63102 63103 63170 63172 63173 63180 63182 63185 63190 63191 63194 63195 63196 63197 63198 63199 63200 63300 63301 63302 63303 63304 63305 63306 63307 63308 63600 63685 63688 63740 63741

CPT Description REMOVAL OF VERTEBRAL BODY REMOVE VERTEBRAL BODY ADD-ON REMOVAL OF VERTEBRAL BODY REMOVE VERTEBRAL BODY ADD-ON REMOVAL OF VERTEBRAL BODY REMOVE VERTEBRAL BODY ADD-ON VERT CORPCT SC&/NRV ROOT;THOR 1 SEG VERT CORPCT SC&/NRV ROOT;LUMB 1 SEG VERT CORPCT SC&/NRV ROOT;T/L EA ADD INCISE SPINAL CORD TRACT(S) DRAINAGE OF SPINAL CYST LAMINECT DRAIN CYST;PERITON/PLEURAL REVISE SPINAL CORD LIGAMENTS REVISE SPINAL CORD LIGAMENTS INCISE SPINAL COLUMN/NERVES INCISE SPINAL COLUMN/NERVES INCISE SPINAL COLUMN/NERVES INCISE SPINAL COLUMN & CORD INCISE SPINAL COLUMN & CORD INCISE SPINAL COLUMN & CORD INCISE SPINAL COLUMN & CORD INCISE SPINAL COLUMN & CORD INCISE SPINAL COLUMN & CORD RELEASE OF SPINAL CORD REMOVAL OF VERTEBRAL BODY REMOVAL OF VERTEBRAL BODY REMOVAL OF VERTEBRAL BODY REMOVAL OF VERTEBRAL BODY REMOVAL OF VERTEBRAL BODY REMOVAL OF VERTEBRAL BODY REMOVAL OF VERTEBRAL BODY REMOVAL OF VERTEBRAL BODY REMOVE VERTEBRAL BODY ADD-ON REMOVE SPINAL CORD LESION INSRT/REPL SP NEUROSTIM GEN/RECV REVISE/REMOVE NEURORECEIVER INSTALL SPINAL SHUNT INSTALL SPINAL SHUNT

A 07

D 07

A 08

D 08

Appendix G – CPT Codes for Measures #1 and #2 *Codes with 50 modifier should be excluded as they are bilateral procedures

CPT Code 64400 64402 64405 64408 64410 64412 64413 64415 64416 64417 64418 64420 64421 64425 64430 64435 64445 64446 64447 64448 64449 64450 64470 64472 64475 64476 64505 64508 64510 64517 64520 64530 64590 64595 64600 64605 64610 64612

CPT Description N BLOCK INJ- TRIGEMINAL N BLOCK INJ- FACIAL N BLOCK INJ- OCCIPITAL N BLOCK INJ- VAGUS N BLOCK INJ- PHRENIC N BLOCK INJ- SPINAL ACCESSOR N BLOCK INJ- CERVICAL PLEXUS N BLOCK INJ- BRACHIAL PLEXUS N BLOCK CONT INFUSE- B PLEX N BLOCK INJ- AXILLARY N BLOCK INJ- SUPRASCAPULAR N BLOCK INJ- INTERCOST- SNG N BLOCK INJ- INTERCOST- MLT N BLOCK INJ ILIO-ING/HYPOGI N BLOCK INJ- PUDENDAL N BLOCK INJ- PARACERVICAL N BLOCK INJ- SCIATIC- SNG N BLK INJ- SCIATIC- CONT INF N BLOCK INJ FEM- SINGLE N BLOCK INJ FEM- CONT INF INJ ANES; LUMB PLEX POST CONT DAILY N BLOCK- OTHER PERIPHERAL INJ PARAVERTEBRAL C/T INJ PARAVERTEBRAL C/T ADD-ON INJ PARAVERTEBRAL L/S INJ PARAVERTEBRAL L/S ADD-ON N BLOCK- SPENOPALATINE GANGL N BLOCK- CAROTID SINUS S/P N BLOCK- STELLATE GANGLION INJ ANES AGT; SUP HYPOGASTR PLEXUS N BLOCK- LUMBAR/THORACIC N BLOCK INJ- CELIAC PELUS INSRT/REPL PERIPH NEUROSTM GEN/RECV REVISE/REMOVE NEURORECEIVER INJECTION TREATMENT OF NERVE INJECTION TREATMENT OF NERVE INJECTION TREATMENT OF NERVE DESTROY NERVE- FACE MUSCLE

A 07

D 07

A 08

D 08

Appendix G – CPT Codes for Measures #1 and #2 *Codes with 50 modifier should be excluded as they are bilateral procedures

CPT Code 64613 64614 64620 64622 64623 64626 64627 64630 64640 64680 64681 64702 64704 64708 64712 64713 64714 64716 64718 64719 64721 64722 64726 64727 64732 64734 64736 64738 64740 64742 64744 64746 64761 64763 64766 64771 64772 64774

A 07 CPT Description DESTROY NERVE- NECK MUSCLE DESTROY NERVE- EXTREM MUSC INJECTION TREATMENT OF NERVE DESTR PARAVERTEBRL NERVE L/S DESTR PARAVERTEBRAL N ADD-ON DESTR PARAVERTEBRL NERVE C/T DESTR PARAVERTEBRAL N ADD-ON INJECTION TREATMENT OF NERVE INJECTION TREATMENT OF NERVE DESTRCT W/WO RAD MON; CELIAC PLEXUS DESTRUC NEURLYT;SUP HYPOGASTRC PLEX REVISE FINGER/TOE NERVE REVISE HAND/FOOT NERVE REVISE ARM/LEG NERVE REVISION OF SCIATIC NERVE REVISION OF ARM NERVE(S) REVISE LOW BACK NERVE(S) REVISION OF CRANIAL NERVE REVISE ULNAR NERVE AT ELBOW REVISE ULNAR NERVE AT WRIST CARPAL TUNNEL SURGERY RELIEVE PRESSURE ON NERVE(S) RELEASE FOOT/TOE NERVE INTERNAL NERVE REVISION INCISION OF BROW NERVE INCISION OF CHEEK NERVE INCISION OF CHIN NERVE INCISION OF JAW NERVE INCISION OF TONGUE NERVE INCISION OF FACIAL NERVE INCISE NERVE- BACK OF HEAD INCISE DIAPHRAGM NERVE INCISION OF PELVIS NERVE INCISE HIP/THIGH NERVE INCISE HIP/THIGH NERVE SEVER CRANIAL NERVE INCISION OF SPINAL NERVE REMOVE SKIN NERVE LESION

D 07

A 08

D 08

Appendix G – CPT Codes for Measures #1 and #2 *Codes with 50 modifier should be excluded as they are bilateral procedures

CPT Code 64776 64778 64782 64783 64784 64786 64787 64788 64790 64792 64795 64802 64804 64809 64818 64820 64821 64822 64823 64856 64866 64868 64870 64872 64874 64876 64885 64886 64890 64891 64892 64893 64895 64896 64897 64898 64901 64902

CPT Description REMOVE DIGIT NERVE LESION DIGIT NERVE SURGERY ADD-ON REMOVE LIMB NERVE LESION LIMB NERVE SURGERY ADD-ON REMOVE NERVE LESION REMOVE SCIATIC NERVE LESION IMPLANT NERVE END REMOVE SKIN NERVE LESION REMOVAL OF NERVE LESION REMOVAL OF NERVE LESION BIOPSY OF NERVE REMOVE SYMPATHETIC NERVES REMOVE SYMPATHETIC NERVES REMOVE SYMPATHETIC NERVES REMOVE SYMPATHETIC NERVES REMOVE SYMPATHETIC NERVES REMOVE SYMPATHESTIC NERVES REMOVE SYMPATHETIC NERVES REMOVE SYMPATHETIC NERVES REPAIR/TRANSPOSE NERVE FUSION OF FACIAL/OTHER NERVE FUSION OF FACIAL/OTHER NERVE FUSION OF FACIAL/OTHER NERVE SUBSEQUENT REPAIR OF NERVE REPAIR & REVISE NERVE ADD-ON REPAIR NERVE/SHORTEN BONE NERVE GRAFT- HEAD OR NECK NERVE GRAFT- HEAD OR NECK NERVE GRAFT- HAND OR FOOT NERVE GRAFT- HAND OR FOOT NERVE GRAFT- ARM OR LEG NERVE GRAFT- ARM OR LEG NERVE GRAFT- HAND OR FOOT NERVE GRAFT- HAND OR FOOT NERVE GRAFT- ARM OR LEG NERVE GRAFT- ARM OR LEG NERVE GRAFT ADD-ON NERVE GRAFT ADD-ON

A 07

D 07

A 08

D 08

Appendix G – CPT Codes for Measures #1 and #2 *Codes with 50 modifier should be excluded as they are bilateral procedures

CPT Code 64905 64907 64999 65210 65220 65222 65235 65260 65265 65270 65280 65285 65286 65400 65410 65420 65426 65430 65435 65436 65450 65600 65710 65730 65750 65755 65765 65767 65770 65771 65772 65775 65780 65781 65782 65800 65805 65810

CPT Description NERVE PEDICLE TRANSFER NERVE PEDICLE TRANSFER NERVOUS SYSTEM SURGERY REMOVE FOREIGN BODY FROM EYE REMOVE FOREIGN BODY FROM EYE REMOVE FOREIGN BODY FROM EYE REMOVE FOREIGN BODY FROM EYE REMOVE FOREIGN BODY FROM EYE REMOVE FOREIGN BODY FROM EYE REPAIR OF EYE WOUND REPAIR OF EYE WOUND REPAIR OF EYE WOUND REPAIR OF EYE WOUND REMOVAL OF EYE LESION BIOPSY OF CORNEA REMOVAL OF EYE LESION REMOVAL OF EYE LESION CORNEAL SMEAR CURETTE/TREAT CORNEA CURETTE/TREAT CORNEA TREATMENT OF CORNEAL LESION REVISION OF CORNEA CORNEAL TRANSPLANT CORNEAL TRANSPLANT CORNEAL TRANSPLANT CORNEAL TRANSPLANT REVISION OF CORNEA CORNEAL TISSUE TRANSPLANT REVISE CORNEA WITH IMPLANT RADIAL KERATOTOMY CORRECTION OF ASTIGMATISM CORRECTION OF ASTIGMATISM OCULR RECNSTR; AMNIOTIC MEMB TPLNT OCULR RECNSTR;LMBL STEM CELL ALLGFT OCULR RECNSTR;LIMBL CONJNCT AUTOGFT DRAINAGE OF EYE DRAINAGE OF EYE DRAINAGE OF EYE

A 07

D 07

A 08

D 08

Appendix G – CPT Codes for Measures #1 and #2 *Codes with 50 modifier should be excluded as they are bilateral procedures

CPT Code 65815 65820 65850 65855 65860 65865 65870 65875 65880 65900 65920 65930 66020 66030 66130 66150 66155 66160 66165 66170 66172 66180 66185 66220 66225 66250 66500 66505 66600 66605 66625 66630 66635 66680 66682 66700 66710 66711

CPT Description DRAINAGE OF EYE RELIEVE INNER EYE PRESSURE INCISION OF EYE LASER SURGERY OF EYE INCISE INNER EYE ADHESIONS INCISE INNER EYE ADHESIONS INCISE INNER EYE ADHESIONS INCISE INNER EYE ADHESIONS INCISE INNER EYE ADHESIONS REMOVE EYE LESION REMOVE IMPLANT OF EYE REMOVE BLOOD CLOT FROM EYE INJECTION TREATMENT OF EYE INJECTION TREATMENT OF EYE REMOVE EYE LESION GLAUCOMA SURGERY GLAUCOMA SURGERY GLAUCOMA SURGERY GLAUCOMA SURGERY GLAUCOMA SURGERY INCISION OF EYE IMPLANT EYE SHUNT REVISE EYE SHUNT REPAIR EYE LESION REPAIR/GRAFT EYE LESION FOLLOW-UP SURGERY OF EYE INCISION OF IRIS INCISION OF IRIS REMOVE IRIS AND LESION REMOVAL OF IRIS REMOVAL OF IRIS REMOVAL OF IRIS REMOVAL OF IRIS REPAIR IRIS & CILIARY BODY REPAIR IRIS & CILIARY BODY DESTRUCTION- CILIARY BODY CILIARY DESTRC; CYCLO-PC TRNSSCLRAL CILIARY BDY DESTRUC; CYCLO-PC ENDO

A 07

D 07

A 08

D 08

Appendix G – CPT Codes for Measures #1 and #2 *Codes with 50 modifier should be excluded as they are bilateral procedures

CPT Code 66720 66740 66761 66762 66770 66820 66821 66825 66830 66840 66850 66852 66920 66930 66940 66982 66983 66984 66985 66986 66999 67005 67015 67025 67027 67028 67030 67031 67036 67038 67039 67040 67101 67105 67107 67108 67110 67112

CPT Description DESTRUCTION- CILIARY BODY DESTRUCTION- CILIARY BODY REVISION OF IRIS REVISION OF IRIS REMOVAL OF INNER EYE LESION INCISION- SECONDARY CATARACT AFTER CATARACT LASER SURGERY REPOSIT IOL W INCISION REMOVAL OF LENS LESION REMOVAL OF LENS MATERIAL REMOVAL OF LENS MATERIAL REMOVAL OF LENS MATERIAL EXTRACTION OF LENS EXTRACTION OF LENS EXTRACTION OF LENS CATARACT SURGERY- COMPLEX CATARACT SURG W/IOL- 1 STAGE CATARACT SURG W/IOL- 1 STAGE INSERT LENS PROSTHESIS EXCHANGE LENS PROSTHESIS EYE SURGERY PROCEDURE PARTIAL REMOVAL OF EYE FLUID RELEASE OF EYE FLUID REPLACE EYE FLUID IMPLANT EYE DRUG SYSTEM INJECTION EYE DRUG INCISE INNER EYE STRANDS LASER SURGERY- EYE STRANDS REMOVAL OF INNER EYE FLUID STRIP RETINAL MEMBRANE LASER TREATMENT OF RETINA LASER TREATMENT OF RETINA REPAIR DETACHED RETINA REPAIR DETACHED RETINA REPAIR DETACHED RETINA REPAIR DETACHED RETINA REPAIR DETACHED RETINA REREPAIR DETACHED RETINA

A 07

D 07

A 08

D 08

OCT 06

OCT 06

JAN 08

Appendix G – CPT Codes for Measures #1 and #2 *Codes with 50 modifier should be excluded as they are bilateral procedures

CPT Code 67113 67115 67120 67121 67141 67145 67208 67210 67218 67220 67221 67225 67227 67228 67229 67250 67255 67299 67311 67312 67314 67316 67318 67320 67331 67332 67334 67340 67345 67350 67399 67412 67420 67500 67505 67515 67570 67599

CPT Description REPAIR RETINAL DETACH W VITRECTOMY RELEASE ENCIRCLING MATERIAL REMOVE EYE IMPLANT MATERIAL REMOVE EYE IMPLANT MATERIAL TREATMENT OF RETINA TREATMENT OF RETINA TREATMENT OF RETINAL LESION TREATMENT OF RETINAL LESION TREATMENT OF RETINAL LESION TREATMENT OF CHOROID LESION OCULAR PHOTODYNAMIC THER EYE PHOTODYNAMIC THER ADD-ON TREATMENT OF RETINAL LESION TREATMENT OF RETINAL LESION TREATMENT RETINOPATHY PRETERM INFAN REINFORCE EYE WALL REINFORCE/GRAFT EYE WALL EYE SURGERY PROCEDURE REVISE EYE MUSCLE REVISE TWO EYE MUSCLES REVISE EYE MUSCLE REVISE TWO EYE MUSCLES REVISE EYE MUSCLE(S) REVISE EYE MUSCLE(S) ADD-ON EYE SURGERY FOLLOW-UP ADD-ON REREVISE EYE MUSCLES ADD-ON REVISE EYE MUSCLE W/SUTURE REVISE EYE MUSCLE ADD-ON DESTROY NERVE OF EYE MUSCLE BIOPSY EYE MUSCLE EYE MUSCLE SURGERY PROCEDURE EXPLORE/TREAT EYE SOCKET EXPLORE/TREAT EYE SOCKET INJECT/TREAT EYE SOCKET INJECT/TREAT EYE SOCKET INJECT/TREAT EYE SOCKET DECOMPRESS OPTIC NERVE ORBIT SURGERY PROCEDURE

A 07

D 07

A 08 D 08 JAN 08

JAN 08

JAN 07

Appendix G – CPT Codes for Measures #1 and #2 *Codes with 50 modifier should be excluded as they are bilateral procedures

CPT Code 67700 67710 67715 67800 67801 67805 67808 67810 67820 67825 67830 67835 67840 67850 67875 67880 67882 67900 67901 67902 67903 67904 67906 67908 67909 67911 67912 67914 67915 67916 67917 67921 67922 67923 67924 67930 67935 67938

CPT Description DRAINAGE OF EYELID ABSCESS INCISION OF EYELID INCISION OF EYELID FOLD REMOVE EYELID LESION REMOVE EYELID LESIONS REMOVE EYELID LESIONS REMOVE EYELID LESION(S) BIOPSY OF EYELID REVISE EYELASHES REVISE EYELASHES REVISE EYELASHES REVISE EYELASHES REMOVE EYELID LESION TREAT EYELID LESION CLOSURE OF EYELID BY SUTURE REVISION OF EYELID REVISION OF EYELID REPAIR BROW DEFECT REPAIR EYELID DEFECT REPAIR EYELID DEFECT REPAIR EYELID DEFECT REPAIR EYELID DEFECT REPAIR EYELID DEFECT REPAIR EYELID DEFECT REVISE EYELID DEFECT REVISE EYELID DEFECT CORR LAGOPHTHALMOS IMPL UP EYELD REPAIR EYELID DEFECT REPAIR EYELID DEFECT REPAIR ECTROPION; EXC TARSAL WEDGE REPAIR OF ECTROPION; EXTENSIVE REPAIR EYELID DEFECT REPAIR EYELID DEFECT REPAIR ENTROPION; EXC TARSAL WEDGE REPAIR OF ENTROPION; EXTENSIVE REPAIR EYELID WOUND REPAIR EYELID WOUND REMOVE EYELID FOREIGN BODY

A 07

D 07

A 08

D 08

Appendix G – CPT Codes for Measures #1 and #2 *Codes with 50 modifier should be excluded as they are bilateral procedures

CPT Code 67950 67961 67966 67971 67973 67974 67975 67999 68020 68040 68100 68110 68115 68130 68135 68200 68320 68325 68326 68328 68330 68335 68340 68360 68362 68371 68399 68400 68420 68440 68500 68505 68510 68520 68525 68530 68540 68550

CPT Description REVISION OF EYELID REVISION OF EYELID REVISION OF EYELID RECONSTRUCTION OF EYELID RECONSTRUCTION OF EYELID RECONSTRUCTION OF EYELID RECONSTRUCTION OF EYELID REVISION OF EYELID INCISE/DRAIN EYELID LINING TREATMENT OF EYELID LESIONS BIOPSY OF EYELID LINING REMOVE EYELID LINING LESION REMOVE EYELID LINING LESION REMOVE EYELID LINING LESION REMOVE EYELID LINING LESION TREAT EYELID BY INJECTION REVISE/GRAFT EYELID LINING REVISE/GRAFT EYELID LINING REVISE/GRAFT EYELID LINING REVISE/GRAFT EYELID LINING REVISE EYELID LINING REVISE/GRAFT EYELID LINING SEPARATE EYELID ADHESIONS REVISE EYELID LINING REVISE EYELID LINING HARV CONJUNCT ALLOGFT LIVING DONR EYELID LINING SURGERY INCISE/DRAIN TEAR GLAND INCISE/DRAIN TEAR SAC INCISE TEAR DUCT OPENING REMOVAL OF TEAR GLAND PARTIAL REMOVAL- TEAR GLAND BIOPSY OF TEAR GLAND REMOVAL OF TEAR SAC BIOPSY OF TEAR SAC CLEARANCE OF TEAR DUCT REMOVE TEAR GLAND LESION REMOVE TEAR GLAND LESION

A 07

D 07

A 08

D 08

Appendix G – CPT Codes for Measures #1 and #2 *Codes with 50 modifier should be excluded as they are bilateral procedures

CPT Code 68700 68705 68720 68745 68750 68760 68761 68770 68801 68815 68816 68840 68850 68899 69000 69005 69020 69100 69105 69110 69120 69140 69145 69150 69155 69200 69205 69220 69222 69300 69310 69320 69399 69400 69401 69405 69410 69440

CPT Description REPAIR TEAR DUCTS REVISE TEAR DUCT OPENING CREATE TEAR SAC DRAIN CREATE TEAR DUCT DRAIN CREATE TEAR DUCT DRAIN CLOSE TEAR DUCT OPENING CLOSE TEAR DUCT OPENING CLOSE TEAR SYSTEM FISTULA DILATE TEAR DUCT OPENING PROBE NASOLACRIMAL DUCT PROBE NASOLACRIMAL DUCT W/ BAL CATH EXPLORE/IRRIGATE TEAR DUCTS INJECTION FOR TEAR SAC X-RAY TEAR DUCT SYSTEM SURGERY DRAIN EXTERNAL EAR LESION DRAIN EXTERNAL EAR LESION DRAIN OUTER EAR CANAL LESION BIOPSY OF EXTERNAL EAR BIOPSY OF EXTERNAL EAR CANAL REMOVE EXTERNAL EAR- PARTIAL REMOVAL OF EXTERNAL EAR REMOVE EAR CANAL LESION(S) REMOVE EAR CANAL LESION(S) EXTENSIVE EAR CANAL SURGERY EXTENSIVE EAR/NECK SURGERY CLEAR OUTER EAR CANAL CLEAR OUTER EAR CANAL CLEAN OUT MASTOID CAVITY CLEAN OUT MASTOID CAVITY REVISE EXTERNAL EAR REBUILD OUTER EAR CANAL REBUILD OUTER EAR CANAL OUTER EAR SURGERY PROCEDURE INFLATE MIDDLE EAR CANAL INFLATE MIDDLE EAR CANAL CATHETERIZE MIDDLE EAR CANAL INSET MIDDLE EAR (BAFFLE) EXPLORATION OF MIDDLE EAR

A 07

D 07

A 08

JAN 08

D 08

Appendix G – CPT Codes for Measures #1 and #2 *Codes with 50 modifier should be excluded as they are bilateral procedures

CPT Code 69450 69501 69502 69505 69511 69530 69535 69540 69550 69552 69554 69601 69602 69603 69604 69605 69610 69620 69631 69632 69633 69635 69636 69637 69641 69642 69643 69644 69645 69646 69650 69660 69661 69662 69666 69667 69670 69676

CPT Description EARDRUM REVISION MASTOIDECTOMY MASTOIDECTOMY REMOVE MASTOID STRUCTURES EXTENSIVE MASTOID SURGERY EXTENSIVE MASTOID SURGERY REMOVE PART OF TEMPORAL BONE REMOVE EAR LESION REMOVE EAR LESION REMOVE EAR LESION REMOVE EAR LESION MASTOID SURGERY REVISION MASTOID SURGERY REVISION MASTOID SURGERY REVISION MASTOID SURGERY REVISION MASTOID SURGERY REVISION TYMPANIC MEMB REPR W/WO SITE PREP REPAIR OF EARDRUM REPAIR EARDRUM STRUCTURES REBUILD EARDRUM STRUCTURES REBUILD EARDRUM STRUCTURES REPAIR EARDRUM STRUCTURES REBUILD EARDRUM STRUCTURES REBUILD EARDRUM STRUCTURES REVISE MIDDLE EAR & MASTOID REVISE MIDDLE EAR & MASTOID REVISE MIDDLE EAR & MASTOID REVISE MIDDLE EAR & MASTOID REVISE MIDDLE EAR & MASTOID REVISE MIDDLE EAR & MASTOID RELEASE MIDDLE EAR BONE REVISE MIDDLE EAR BONE REVISE MIDDLE EAR BONE REVISE MIDDLE EAR BONE REPAIR MIDDLE EAR STRUCTURES REPAIR MIDDLE EAR STRUCTURES REMOVE MASTOID AIR CELLS REMOVE MIDDLE EAR NERVE

A 07

D 07

A 08

D 08

Appendix G – CPT Codes for Measures #1 and #2 *Codes with 50 modifier should be excluded as they are bilateral procedures

CPT Code 69700 69711 69714 69715 69717 69718 69720 69725 69799 69801 69802 69805 69806 69820 69840 69905 69910 69915 69930 69949 69950 69955 69960 69970 69979 92020 92504 95920 96440 97799 99195

CPT Description CLOSE MASTOID FISTULA REMOVE/REPAIR HEARING AID IMPLANT TEMPLE BONE W/STIMUL TEMPLE BNE IMPLNT W/STIMULAT TEMPLE BONE IMPLANT REVISION REVISE TEMPLE BONE IMPLANT RELEASE FACIAL NERVE RELEASE FACIAL NERVE MIDDLE EAR SURGERY PROCEDURE INCISE INNER EAR INCISE INNER EAR EXPLORE INNER EAR EXPLORE INNER EAR ESTABLISH INNER EAR WINDOW REVISE INNER EAR WINDOW REMOVE INNER EAR REMOVE INNER EAR & MASTOID INCISE INNER EAR NERVE IMPLANT COCHLEAR DEVICE INNER EAR SURGERY PROCEDURE INCISE INNER EAR NERVE RELEASE FACIAL NERVE RELEASE INNER EAR CANAL REMOVE INNER EAR LESION TEMPORAL BONE SURGERY SPECIAL EYE EVALUATION EAR MICROSCOPY EXAMINATION INTRAOP NERVE TEST ADD-ON CHEMOTHERAPY- INTRACAVITARY PHYSICAL MEDICINE PROCEDURE PHLEBOTOMY

A 07

D 07

A 08

D 08